腹腔镜胆囊切除术术后 ESP 阻滞镇痛与阿片类药物镇痛的效果比较

Salma Azad Tanni
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摘要

背景:在我国,腹腔镜胆囊切除术术后镇痛中使用脊柱后凸肌平面阻滞(ESP)的作用尚未得到研究。因此,本研究旨在比较 ESP 阻滞与阿片类药物镇痛在腹腔镜胆囊切除术术后疼痛控制中的有效性。研究目的本研究旨在评估 ESP 阻滞术后镇痛与阿片类镇痛的效果比较。方法这项横断面比较研究在 CMH 的外科与麻醉科合作下进行,为期 6 个月。研究开始前,已获得 DGMS 军队伦理委员会的正式伦理许可。共有 60 名患者计划在全身麻醉下进行腹腔镜胆囊切除术,他们被随机分为两组(每组 30 名患者),其中 30 名患者同时接受 GA 和超声引导 ESP 阻滞治疗,被分配到 E 组,30 名患者接受 GA 和阿片类镇痛治疗,被分配到 N 组。收集数据后,使用 SPSS 24 对数据进行分析。结果就年龄、性别、体重指数和 ASA 分级而言,两组受试者的人口统计学特征完全相同(P>0.05)。术前、术后或恢复室心率(P>0.05)和平均动脉压(P>0.05)均无明显差异。在恢复室,E 组的疼痛明显少于 N 组(3.67±0.802 vs 4.3±0.877;P<0.05)。在 6、12 和 24 小时的随访中,E 组也有类似的改善(所有随访中,P<0.05)。术后 1、12 和 24 小时,N 组的镇痛剂用量同样较高(所有随访数据中,P<0.05)。除了恶心在 N 组更常见(P<0.05)外,两组的并发症相似。......
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Effectiveness of ESP Block as Post-Operative Analgesia in Comparison with Opioid Analgesia for Laparoscopic Cholecystectomy
Background: In our country, the role of Erector Spinae Plane Block (ESP) for post-operative analgesia in laparoscopic cholecystectomy has not yet been investigated. As a result, the study was designed to compare the effectiveness of ESP block as post-operative analgesia to opioid analgesia for pain control following Laparoscopic Cholecystectomy. Objectives: The aim of the study was to evaluate the effectiveness of ESP block as post-operative analgesia in comparison with opioid analgesia. Methods: This cross-sectional comparative study was conducted at the department of surgery with collaboration of department of Anaesthesiology in CMH for 6 months of period. Before commencement of the study formal ethical clearance was taken from the Ethical Committee of DGMS Army. Total 60 patients, scheduled for laparoscopic cholecystectomy under general anesthesia were included in this study and randomly divided into two groups (30 patients in each group). total 30 Patients, received both GA and ultrasound guided ESP block were assigned as group E and 30 Patients, received GA and opioid analgesia were in group N. Informed written consent was taken from each subject and ethical measures were followed strictly in whole study. Following data collection, data were analyzed by the SPSS 24. Results: In terms of age, sex, BMI and ASA grading, the two groups had identical demographic features (p>0.05 in all cases). There was no significant difference in pre-operative, post-operative, or recovery room heart rate (p>0.05) or mean arterial pressure (p>0.05). In the recovery room, group E has significantly less pain than group N (3.67±0.802 vs 4.3±0.877; p<0.05). A similar improvement was seen in group E at 6, 12 and 24 hours (p<0.05 in all follow ups). Post-operative analgesic consumption was similarly higher in group N at 1, 12, and 24 hours (p<0.05 in all follow up). Except for nausea, which was more common in group N (p<0.05), complications were similar in both groups. ......
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