临床外科杂志 ›› 2019, Vol. 27 ›› Issue (11): 984-986.doi: 10.3969/j.issn.1005-6483.2019.11.019

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超声引导竖脊肌平面阻滞对多发肋骨骨折术后镇痛效果的影响

  

  1. 武汉大学人民医院麻醉科
  • 出版日期:2019-11-20 发布日期:2019-11-20

Effect of ultrasoundguided single erector spinae plane block on postoperative pain in patients with multiple rib fracture

  • Online:2019-11-20 Published:2019-11-20

摘要: 目的:观察超声引导竖脊肌平面(erector spinae plane,ESP)阻滞对肋骨骨折病人术后镇痛效果的影响。
方法:选择择期行全麻肋骨骨折手术治疗的病人,随机分为两组:ESP组和对照组,每组30例。麻醉诱导后,ESP组行超声引导下术侧ESP阻滞,对照组注射等容积的生理盐水,术后均行病人自控静脉镇痛(PCIA)。记录术中病人生命体征、麻醉药物用量,手术后VAS评分和PrinceHenry(PH)疼痛评分,PCIA按压次数和输注总量,不良反应发生情况。
结果:两组病人术中生命体征差异无统计学意义,手术中ESP组瑞芬太尼使用量少于对照组(P<0.05),术后48小时内 ESP组镇痛泵按压次数和输注总量明显少于对照组(P<0.05),ESP组术后VAS评分和PH疼痛评分明显低于对照组(P<0.05)。
结论:超声引导下竖脊肌平面阻滞能减少肋骨骨折病人围术期阿片类药物的用量,减少PCIA 的按压次数和输注总量,减轻术后疼痛。

关键词: 超声引导;肋骨骨折;竖脊肌平面阻滞 

Abstract: Objective:To observe the clinical effects of ultrasoundguided erector spinae plane(ESP)block on postoperative pain in patients with multiple fractured ribs.Methods:A total of 60 patients with unilateral fractured ribs were randomly divided into 2 groups:ESP group and control group,n=30 in each group.After induction of anesthesia,ultrasoundguided unilateral ESP block were performed in ESP group,while control group received the equal volume of normal saline.All patients received patientcontrolled intravenous analgesia(PCIA)after surgery.Postoperative scores of VAS and PrinceHenry(PH)pain scale were evaluated.The consumption of propofol and remifentanil were recorded,meanwhile PCIA delivered doses and attempts within 48h after surgery were recorded.The adverse effects were recorded.Results:There were no statistical difference in the vital signs and postoperative complications in two groups.Compared with control group the consuption of remifentanil were significantly reduced in ESP group(P<0.05).PCIA delivered dose and attempts were significantly reduced in ESP group than control group(P<0.05).The VAS scores and PH pain scale at postoperative were significantly lower in ESP group than control group(P<0.05).Conclusion:Ultrasoundguided ESP block significantly reduces perioperative opioids consumption,PCIA delivered dose and attempts and can provides good analgesic effects for patients with multiple fractured ribs.


Key words: ultrasoundguided, rib fractures, erector spinae plane block

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