立体脊柱平面阻塞在腰椎脊柱融合手术后的多模式止痛:一个盲目的随机的安慰剂受控试验
Ilse H van de Wijgert1,2,3, Maaike G E Fenten1, Akkie Rood4
1From the Department of Anesthesiology, Sint Maartenskliniek, Nijmegen, the Netherlands.
Anesthesia and analgesia
|July 2, 2025
概括
双边勃起器脊柱平面阻塞 (ESPB) 与罗皮瓦卡因并没有显著降低腰椎融合手术后的早期术后疼痛或阿片类药物使用. 这项研究表明,ESPB在这种患者群体中的益处有限.
科学领域:
- 麻醉学 麻醉学
- 疼痛管理 疼痛管理
- 脊柱外科手术 脊柱外科手术
背景情况:
- 腰椎手术后的术后疼痛往往需要多模式止痛,包括阿片类药物.
- 地方区域麻醉技术,如勃起器脊柱平面块 (ESPB),正在探索减轻疼痛.
- 评估ESPB在腰椎脊柱融合中的有效性对于优化疼痛管理至关重要.
研究的目的:
- 评估双边ESPB对早期术后疼痛强度的影响.
- 为了确定双边ESPB对腰椎脊柱融合后阿片类药物消费的影响.
- 调查二次结果,包括恢复质量和长期疼痛和阿片类药物使用.
主要方法:
- 一个随机的,盲目的,安慰剂对照试验,涉及76名患者接受腰椎脊髓融合.
- 参与者接受双边ESPB与罗皮瓦卡因或安慰剂 (正常盐水) 手术后.
- 主要结局:麻醉后1小时的疼痛强度 (数值评分表);次要结局:阿片类药物的使用,第一次阿片类药物的时间,恢复质量.
主要成果:
- 罗皮瓦卡因和安慰剂组之间的1小时术后疼痛 (NRS) 没有显著差异 (P = .56).
- 类似的中位数12小时的阿片类药物消费和时间第一次使用阿片类药物之间的组.
- 在30天后,恢复质量或疼痛/阿片类药物使用没有显著差异.
结论:
- 双边ESPB与罗皮瓦卡因并没有有效地减少腰椎脊髓融合患者的早期术后疼痛或阿片类药物使用.
- 该研究表明,双边ESPB在这种程序的多式模式止痛策略中具有有限的益处.
- 基于这些发现,对所有腰椎手术进行双边ESPB的例行应用不建议.
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