腰椎手术患者胸腰椎筋膜间平面阻滞与标准护理的镇痛效果--随机对照试验

IF 0.2 Q4 ANESTHESIOLOGY Journal of Neuroanaesthesiology and Critical Care Pub Date : 2024-05-02 DOI:10.1055/s-0044-1782506
Suman Saini, Ananya Sharma, Anju Gupta, Dipankar S. Mankotia, Tankeswar Boruah
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引用次数: 0

摘要

背景接受脊柱手术的患者术后往往会感到剧烈疼痛。包括区域阻滞在内的多模式镇痛可提供最佳镇痛效果。胸腰椎筋膜间平面(TLIP)阻滞可为这些患者提供良好的镇痛效果。材料 50 名年龄在 18 至 60 岁之间、同意在平衡全身麻醉下接受择期腰椎手术的成人被分为两个相同的小组(T 组:接受双侧 TLIP 阻滞,C 组:接受常规阿片类药物镇痛)。所有患者均在麻醉后护理病房由一名不了解研究方案的独立麻醉师进行护理。术后疼痛通过视觉模拟量表(VAS)进行评估。此外,还记录了首次镇痛抢救时间、吗啡总用量、并发症和患者满意度。结果 对照组术后 12 小时内的平均 VAS 评分明显高于对照组。T 组和 C 组患者首次镇痛需求的平均时间分别为(404.4 ± 25.1)分钟和(150.2 ± 12.4)分钟(P < 0.001)。C 组患者 24 小时内的吗啡消耗量也明显更高(3.36 ± 1.04 vs. 7.84 ± 1.43;p < 0.001)。C 组术中芬太尼的平均消耗量明显更高(122.4 ± 16.4 µg 和 140.4 ± 21.7 µg; p = 0.001)。两组的并发症相似。然而,T 组患者的满意度明显更高(p < 0.001)。结论 与接受标准全身麻醉并使用阿片类镇痛药的患者相比,TLIP阻滞可提供更好的镇痛效果,减少阿片类药物的消耗,并提高患者满意度。因此,TLIP阻滞可作为腰椎手术患者多模式镇痛的一个组成部分。
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Analgesic Efficacy of Thoracolumbar Interfascial Plane Block versus Standard Care in Patients Undergoing Lumbar Spinal Surgeries—A Randomized Controlled Trial
Background Patients who undergo spine surgery often experience severe pain postoperatively. Multimodal analgesia inclusive of a regional block provides optimal pain relief. Thoracolumbar interfascial plane (TLIP) block may provide promising analgesia in these patients. Materials Fifty consenting adults aged between 18 and 60 years undergoing elective lumbar spinal surgeries under balanced general anesthesia were divided into two equal groups (group T: received bilateral TLIP block, and group C: received conventional opioid analgesia). All the patients were taken care of by an independent anesthesiologist unaware of the study protocol in the postanesthesia care unit. The postoperative pain was assessed by visual analog scale (VAS). Time to first rescue analgesia, total morphine consumption, complications, and patient satisfaction were also recorded. Results Postoperative mean VAS scores till 12 hours were significantly higher in the control group. The mean time to the first analgesic requirement among group T and group C patients was 404.4 ± 25.1 and 150.2 ± 12.4 minutes, respectively (p < 0.001). Morphine consumptions in 24 hours were also significantly higher in group C (3.36 ± 1.04 vs. 7.84 ± 1.43; p < 0.001). Mean intraoperative fentanyl consumption was significantly more in group C (122.4 ± 16.4 µg and 140.4 ± 21.7 µg; p = 0.001). Complications were similar in both groups. However, patient satisfaction was significantly higher in group T (p < 0.001). Conclusion TLIP block provided superior analgesia, decreased opioid consumption, and improved patient satisfaction as compared with patients receiving standard general anesthesia with opioid analgesics. Hence, TLIP block could be a component of multimodal analgesia in patients undergoing lumbar spine surgeries.CTRI No.: CTRI/2021/03/031682
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来源期刊
Journal of Neuroanaesthesiology and Critical Care
Journal of Neuroanaesthesiology and Critical Care Medicine-Critical Care and Intensive Care Medicine
CiteScore
0.50
自引率
0.00%
发文量
29
审稿时长
15 weeks
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