文章摘要

超声引导下竖脊肌平面阻滞在经皮肾镜取石术中的应用

作者: 1王友宁, 1刘学胜
1 安徽医科大学第一附属医院麻醉科,合肥 230000
通讯: 刘学胜 Email: liuxuesheng@ahmu.edu.cn
DOI: 10.3978/j.issn.2095-6959.2020.09.027

摘要

目的:评估超声引导下竖脊肌平面阻滞(erector spinae plane block,ESPB)在经皮肾镜取石术中的临床效果与应用价值。方法:择期行单侧经皮肾镜取石术患者70例并随机分成2组(n=35),E组行超声引导下T10水平ESPB后接受气管插管下全凭静脉麻醉,C组在气管插管下行全凭静脉麻醉。记录患者术中瑞芬太尼总用量及手术时长,术后2,6,12,18,24,48 h静息和运动时VAS评分、急性镇痛需求次数及术后不良反应发生的情况。结果:相比与C组,E组患者术中瑞芬太尼用量明显减少(P<0.05),术后第6,12 h静息时和运动时VAS评分明显降低(P<0.05),术后急性镇痛需求次数和恶心发生率显著减少(P<0.05)。结论:超声引导下ESPB应用于经皮肾镜取石术可显著减少术中阿片类药物用量,有效改善术后疼痛,降低术后不良反应发生率,具有不错的临床应用价值。
关键词: 经皮肾镜取石术;竖脊肌平面阻滞;术后镇痛

Application of the ultrasound-guided erector spinae plane block in percutaneous nephrolithotomy

Authors: 1WANG Youning, 1LIU Xuesheng
1 Department of Anesthesiology, First Affiliated Hospital of Anhui Medical University, Hefei 230000, China

CorrespondingAuthor: LIU Xuesheng Email: liuxuesheng@ahmu.edu.cn

Abstract

Objective: To evaluate the clinical effect and application value of the ultrasound-guided erector spinae plane block (ESPB) in percutaneous nephrolithotomy. Methods: Seventy patients scheduled for percutaneous nephrolithotomy are randomly assigned into two groups (n=35): group E underwent ultrasound-guided T10 level ESPB and received intravenous anesthesia with tracheal intubation, group C received intravenous anesthesia with endotracheal tube. The total dosage of remifentanil during operation and the length of operation were recorded. VAS scores at rest and during activity were also recorded postoperative 2, 6, 12, 18, 24, 48 h. The number of acute analgesia needs and the occurrence of postoperative adverse effect. Results: The difference of dosage of remifentanil during operation and postoperative 6, 12 h VAS scores (rest and activity) in the two groups was statistically significant (P<0.05), Compared with group C, the number of acute analgesia needs and incidence of nausea ware lower in group E. Conclusion: Ultrasound-guided ESPB can significantly reduce the dosage of opioids during operation, effectively improve postoperative pain and reduce the incidence of postoperative adverse reactions in percutaneous nephrolithotomy. It has good clinical application value.
Keywords: percutaneous nephrolithotomy; erector spinae plane block; post-operative analgesia