Comparison of ultrasound-guided erector spinal muscle plane block and quadratus block for laparoscopic renal cancer resection:A single-center,double-blind, randomized controlled trial.

Meng Zhang, Shuchuan Zhao, Mingfang Li, Yue Liu, Hu Li, Peng Su, Guangmin Xu
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Abstract

Objective:This study investigated the effects of ultrasound-guided erector spinal muscle plane block (ESPB) and quadratus muscle block (QLB) on the quality of analgesia and recovery after laparoscopic nephrectomy.Design:randomized, controlled, double-blind study.Setting: A single tertiary care academic medical center,include anesthesia preparation room, operating room, anesthesia recovery room and ward.Patients:Aged 18-70years,ASA grades I-III,elective laparoscopic partial nephrectomy or radical nephrectomy and 54 patients were included in the statistical analysis.Interventions:All included patients were randomassigned to the erector spinal muscle plane block or the quadratus block,and all patients underwent morphine pump controlled analgesia.Results:The study found that ultrasound-guided ESPB had a higher incidence of hypotension than QLB at the T1 time point, but it did not significantly increase the intraoperative dose of the vasoactive drug used. Patients in the ESPB group showed significant improvement in resting NRS pain scores at 0.5h,number of morphine pumps at 6h and 24h, cumulative morphine equivalent consumed 6h after surgery, and QOR-15 score at 24 h after surgery, and shortened hospital stay.Conclusions:Compared with QLB,ESPB has certain advantages in analgesia and recovery quality after laparoscopic nephrectomy, and shows opioid frugality effect at individual postoperative time points.
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腹腔镜肾癌切除术中超声引导下竖脊肌平面阻滞与四角肌阻滞的比较:一项单中心、双盲、随机对照试验。
目的:本研究探讨了超声引导下竖脊肌平面阻滞(ESPB)和四角肌阻滞(QLB)对腹腔镜肾切除术后镇痛质量和恢复的影响:患者:年龄18-70岁,ASA分级I-III级,选择性腹腔镜肾部分切除术或根治性肾切除术,54例患者纳入统计分析。结果:研究发现,超声引导下ESPB在T1时间点的低血压发生率高于QLB,但术中使用的血管活性药物剂量并未显著增加。ESPB组患者在术后0.5小时静息NRS疼痛评分、术后6小时和24小时吗啡泵次数、术后6小时累计吗啡当量消耗量、术后24小时QOR-15评分等方面均有明显改善,并缩短了住院时间。结论:与QLB相比,ESPB在腹腔镜肾切除术后镇痛和恢复质量方面具有一定优势,并在术后个别时间点显示出阿片类药物的节俭效应。
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