超声引导下竖脊肌平面阻滞在老年腰椎后路手术患者术后镇痛中的应用效果

The effect of ultrasound-guided erector spinal plane block for postoperative analgesia in elderly patients with posterior lumbar spine surgery

目的探讨超声引导下竖脊肌平面阻滞(ESPB)在老年腰椎后路手术患者术后镇痛中的应用效果。方法选取2019年3月至2020年12月于本院接受腰椎后路手术治疗的40例老年患者作为研究对象,采用随机数字表法分为实验组和对照组,每组20例。两组均行全身静脉麻醉,实验组于麻醉诱导后实施ESPB,对照组不进行任何神经阻滞,比较两组术后不同时间视觉模拟评分法(VAS)评分、不良反应发生率、术后镇痛补救追加地佐辛次数、镇痛满意度及术中舒芬太尼用量。结果术后1、6、12、24、48 h,实验组VAS评分均低于对照组,差异有统计学意义(P<0.05)。实验组不良反应发生率(5.00%)低于对照组(35.00%),差异有统计学意义(P<0.05)。实验组术后镇痛补救追加地佐辛次数略低于对照组,但差异无统计学意义;实验组镇痛满意度高于对照组,术中舒芬太尼用量少于对照组,差异有统计学意义(P<0.05)。结论ESPB应用于老年腰椎后路手术患者术后镇痛中,能减轻患者术后疼痛,减少术中舒芬太尼用量及不良反应的发生,提高术后镇痛满意度,值得临床推广应用。

Objective To investigate effect of ultrasound-guided erector spinae plane block(ESPB)for postoperative analgesia in elderly padoi:tients with posterior lumbar spine surgery.Methods 40 elderly patients who received posterior lumbar spine surgery in our hospital from March 2019 to December 2020 were selected as the research subjects,and they were divided into experimental group and control group according to random number table method,with 20 cases in each group.Both groups underwent total intravenous anesthesia,the experimental group received ultrasoundguided ESPB after induction of anesthesia,while the control group was not undergo any nerve block,the visual analogue scale(VAS)scores at different time after operation,the incidence of adverse reactions,the number of additional dezocine in postoperative analgesic rescue,analgesic satisfaction and intraoperative sufentanil dosage were compared between the two groups.Results At 1,6,12,24 and 48 h after operation,the VAS score of the experimental group was lower than those of the control group,and the difference was statistically significant(P<0.05).The incidence of adverse reactions in the experimental group(5.00%)was lower than that in the control group(35.00%),and the difference was statistically significant(P<0.05).The number of additional dezocine in postoperative analgesic rescue in the experimental group was slightly lower than that in the control group,but the difference was not statistically significant.The analgesic satisfaction of the experimental group was higher than that of the control group,and the intraoperative dosage of sufentanil was less than that of the control group,and the difference was statistically significant(P<0.05).Conclusion The application of ESPB in postoperative analgesia for elderly patients with posterior lumbar spine surgery can reduce postoperative pain,reduce intraoperative sufentanil dosage and the occurrence of adverse reactions,and improve the satisfaction of patients with postoperative analgesia,which is worthy of clinical promotion and application.