{"title":"胸腔镜肺叶切除术后老年患者术后镇痛的连续脊束肌平面阻滞疗法","authors":"","doi":"10.1016/j.jopan.2024.01.001","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>The purpose of this study was to compare the effect of ultrasound-guided continuous erector spinae plane block to continuous thoracic paravertebral block on postoperative analgesia in elderly patients who underwent thoracoscopic lobectomy.</div></div><div><h3>Design</h3><div>Randomized controlled trial.</div></div><div><h3>Methods</h3><div>Elderly patients (N = 50) who underwent nonemergent thoracoscopic lobectomy in the thoracic surgery department of our hospital from January 2019 to December 2020 were selected and randomly divided into continuous erector spinae block (ESPB; n = 25) group and continuous thoracic paravertebral block (TPVB; n = 25) group. The patients in the two groups were guided by ultrasound with ESPB or TPVB before anesthesia induction. The visual analog scale at rest and cough in 2 hours, 6 hours, 8 hours, 12 hours, 24 hours, 48 hours after surgery, the supplementary analgesic dosage of tramadol, time of tube placement, the stay time in postanesthesia care unit (PACU), the first ambulation time after surgery, the length of postoperative hospital stay and postoperative complications were recorded.</div></div><div><h3>Findings</h3><div>There were no significant differences between the two groups in visual analog scale score at rest and cough at each time point and supplementary analgesic dosage of tramadol within 48 hours after surgery (<em>P</em> > .05). The time of tube placement and the postoperative hospital stay in ESPB group was significantly shorter than that in TPVB group (<em>P</em> < .05). There were no differences in PACU residence time and first ambulation time between the two groups (<em>P</em> > .05). There were 4 patients in TPVB group and 2 patients in ESPB group who had nausea and vomiting (<em>P</em> > .05), 1 case of pneumothorax and 1 case of fever in the TPVB group. There were no incision infections or respiratory depression requiring clinical intervention in either group.</div></div><div><h3>Conclusions</h3><div>Both ESPB and TPVB alleviated the patients postoperative pain effectively for elderly patients underwent thoracoscopic lobectomy. Compared with TPVB, patients with ESPB have a shorter tube placement time, fewer complications and faster postoperative recovery.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"39 5","pages":"Pages 887-891"},"PeriodicalIF":1.6000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Continuous Erector Spinae Plane Block for Postoperative Analgesia in Elderly Patients After Thoracoscopic Lobectomy\",\"authors\":\"\",\"doi\":\"10.1016/j.jopan.2024.01.001\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Purpose</h3><div>The purpose of this study was to compare the effect of ultrasound-guided continuous erector spinae plane block to continuous thoracic paravertebral block on postoperative analgesia in elderly patients who underwent thoracoscopic lobectomy.</div></div><div><h3>Design</h3><div>Randomized controlled trial.</div></div><div><h3>Methods</h3><div>Elderly patients (N = 50) who underwent nonemergent thoracoscopic lobectomy in the thoracic surgery department of our hospital from January 2019 to December 2020 were selected and randomly divided into continuous erector spinae block (ESPB; n = 25) group and continuous thoracic paravertebral block (TPVB; n = 25) group. The patients in the two groups were guided by ultrasound with ESPB or TPVB before anesthesia induction. The visual analog scale at rest and cough in 2 hours, 6 hours, 8 hours, 12 hours, 24 hours, 48 hours after surgery, the supplementary analgesic dosage of tramadol, time of tube placement, the stay time in postanesthesia care unit (PACU), the first ambulation time after surgery, the length of postoperative hospital stay and postoperative complications were recorded.</div></div><div><h3>Findings</h3><div>There were no significant differences between the two groups in visual analog scale score at rest and cough at each time point and supplementary analgesic dosage of tramadol within 48 hours after surgery (<em>P</em> > .05). The time of tube placement and the postoperative hospital stay in ESPB group was significantly shorter than that in TPVB group (<em>P</em> < .05). There were no differences in PACU residence time and first ambulation time between the two groups (<em>P</em> > .05). There were 4 patients in TPVB group and 2 patients in ESPB group who had nausea and vomiting (<em>P</em> > .05), 1 case of pneumothorax and 1 case of fever in the TPVB group. There were no incision infections or respiratory depression requiring clinical intervention in either group.</div></div><div><h3>Conclusions</h3><div>Both ESPB and TPVB alleviated the patients postoperative pain effectively for elderly patients underwent thoracoscopic lobectomy. Compared with TPVB, patients with ESPB have a shorter tube placement time, fewer complications and faster postoperative recovery.</div></div>\",\"PeriodicalId\":49028,\"journal\":{\"name\":\"Journal of Perianesthesia Nursing\",\"volume\":\"39 5\",\"pages\":\"Pages 887-891\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2024-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Perianesthesia Nursing\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1089947224000017\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"NURSING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Perianesthesia Nursing","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1089947224000017","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"NURSING","Score":null,"Total":0}
Continuous Erector Spinae Plane Block for Postoperative Analgesia in Elderly Patients After Thoracoscopic Lobectomy
Purpose
The purpose of this study was to compare the effect of ultrasound-guided continuous erector spinae plane block to continuous thoracic paravertebral block on postoperative analgesia in elderly patients who underwent thoracoscopic lobectomy.
Design
Randomized controlled trial.
Methods
Elderly patients (N = 50) who underwent nonemergent thoracoscopic lobectomy in the thoracic surgery department of our hospital from January 2019 to December 2020 were selected and randomly divided into continuous erector spinae block (ESPB; n = 25) group and continuous thoracic paravertebral block (TPVB; n = 25) group. The patients in the two groups were guided by ultrasound with ESPB or TPVB before anesthesia induction. The visual analog scale at rest and cough in 2 hours, 6 hours, 8 hours, 12 hours, 24 hours, 48 hours after surgery, the supplementary analgesic dosage of tramadol, time of tube placement, the stay time in postanesthesia care unit (PACU), the first ambulation time after surgery, the length of postoperative hospital stay and postoperative complications were recorded.
Findings
There were no significant differences between the two groups in visual analog scale score at rest and cough at each time point and supplementary analgesic dosage of tramadol within 48 hours after surgery (P > .05). The time of tube placement and the postoperative hospital stay in ESPB group was significantly shorter than that in TPVB group (P < .05). There were no differences in PACU residence time and first ambulation time between the two groups (P > .05). There were 4 patients in TPVB group and 2 patients in ESPB group who had nausea and vomiting (P > .05), 1 case of pneumothorax and 1 case of fever in the TPVB group. There were no incision infections or respiratory depression requiring clinical intervention in either group.
Conclusions
Both ESPB and TPVB alleviated the patients postoperative pain effectively for elderly patients underwent thoracoscopic lobectomy. Compared with TPVB, patients with ESPB have a shorter tube placement time, fewer complications and faster postoperative recovery.
期刊介绍：
The Journal of PeriAnesthesia Nursing provides original, peer-reviewed research for a primary audience that includes nurses in perianesthesia settings, including ambulatory surgery, preadmission testing, postanesthesia care (Phases I and II), extended observation, and pain management. The Journal provides a forum for sharing professional knowledge and experience relating to management, ethics, legislation, research, and other aspects of perianesthesia nursing.
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