Introduction: Ambulatory surgery requires effective analgesia with few side effects to allow a return home on the day of surgery. The aim of the study was to compare the efficacy of intrathecal morphine (Ram) and erec...Introduction: Ambulatory surgery requires effective analgesia with few side effects to allow a return home on the day of surgery. The aim of the study was to compare the efficacy of intrathecal morphine (Ram) and erector spinae plane block (ESP) in outpatient abdominal wall surgery. Methodology: Thirty-six patients were randomized into two groups. The ESP group (n = 23) benefited from the ESP block with bupivacaine 5% (20 ml) followed by spinal anesthesia with bupivacaine (7.5 mg) and sufenta (2.5 µg). The Ram group (n = 13) benefited from spinal anesthesia with bupivacaine (7.5 mg), sufenta (2.5 µg) and morphine (100 µg). The primary endpoint was whether or not to return home on the day of surgery. The secondary endpoint was the pain score by the visual analog scale (VAS) in the post-intervention monitoring room (SSPI). After 2 hours (H2) and one day (D1) after surgery, the morphine consumption in the immediate postoperative period (mg) and the undesirable effects. Results: Inguinal hernia surgery predominated (n = 30). No difference in age (45.05 vs 50.7;p = 0.4), ASA score (1.43 vs 1.53;p = 0.57). All patients (n = 36) returned home on the day of surgery. No difference in postoperative pain in SSPI (p = 0.6), 2 hours after surgery (p = 0.40) and the day after surgery (p = 0.6). Postoperative morphine consumption was identical (0.9 mg vs 0.2 mg, p = 0.2). There were 2 urinary retentions in the Ram group. Conclusion: The erector spinae plane block and intrathecal morphine are well tolerated and perfectly compatible with the requirements of outpatient abdominal wall surgery.展开更多
目的:比较腹腔镜胃癌根治术后应用不同剂量布比卡因竖脊肌平面阻滞(ESPB)的镇痛效果。方法:选取2019年12月至2022年12月于新乡市中心医院行ESPB腹腔镜胃癌根治术的患者,其中45例(研究1组)采用30 mL 0.25%(质量分数)布比卡因,与研究1组...目的:比较腹腔镜胃癌根治术后应用不同剂量布比卡因竖脊肌平面阻滞(ESPB)的镇痛效果。方法:选取2019年12月至2022年12月于新乡市中心医院行ESPB腹腔镜胃癌根治术的患者,其中45例(研究1组)采用30 mL 0.25%(质量分数)布比卡因,与研究1组性别、年龄、分期等资料匹配的45例(研究2组)采用20 mL 0.25%布比卡因。记录两组ESPB后2(T1)、4(T2)、8(T3)、12(T4)、24(T5)、48(T6)h时疼痛视觉模拟评分(VAS),术后24 h曲马多使用率、镇痛泵按压次数和术后24 h镇痛满意度,术后不良反应发生情况。结果:静息和咳嗽状态下两组患者VAS评分均随时间延长先升高后降低;研究1组静息状态下T2~T6、咳嗽状态下T1~T6的VAS评分均低于研究2组(P<0.05)。研究1组术后镇痛满意度评分高于研究2组(P<0.05),曲马多使用率、镇痛泵按压次数低于研究2组(P<0.05)。研究1组和2组恶心呕吐、眩晕、胸闷、瘙痒等总不良反应发生率分别为31.1%和35.6%,差异无统计学意义(P>0.05)。结论:腹腔镜胃癌根治术后30 mL 0.25%布比卡因ESPB的镇痛效果更为理想。展开更多
文摘Introduction: Ambulatory surgery requires effective analgesia with few side effects to allow a return home on the day of surgery. The aim of the study was to compare the efficacy of intrathecal morphine (Ram) and erector spinae plane block (ESP) in outpatient abdominal wall surgery. Methodology: Thirty-six patients were randomized into two groups. The ESP group (n = 23) benefited from the ESP block with bupivacaine 5% (20 ml) followed by spinal anesthesia with bupivacaine (7.5 mg) and sufenta (2.5 µg). The Ram group (n = 13) benefited from spinal anesthesia with bupivacaine (7.5 mg), sufenta (2.5 µg) and morphine (100 µg). The primary endpoint was whether or not to return home on the day of surgery. The secondary endpoint was the pain score by the visual analog scale (VAS) in the post-intervention monitoring room (SSPI). After 2 hours (H2) and one day (D1) after surgery, the morphine consumption in the immediate postoperative period (mg) and the undesirable effects. Results: Inguinal hernia surgery predominated (n = 30). No difference in age (45.05 vs 50.7;p = 0.4), ASA score (1.43 vs 1.53;p = 0.57). All patients (n = 36) returned home on the day of surgery. No difference in postoperative pain in SSPI (p = 0.6), 2 hours after surgery (p = 0.40) and the day after surgery (p = 0.6). Postoperative morphine consumption was identical (0.9 mg vs 0.2 mg, p = 0.2). There were 2 urinary retentions in the Ram group. Conclusion: The erector spinae plane block and intrathecal morphine are well tolerated and perfectly compatible with the requirements of outpatient abdominal wall surgery.
文摘目的:比较腹腔镜胃癌根治术后应用不同剂量布比卡因竖脊肌平面阻滞(ESPB)的镇痛效果。方法:选取2019年12月至2022年12月于新乡市中心医院行ESPB腹腔镜胃癌根治术的患者,其中45例(研究1组)采用30 mL 0.25%(质量分数)布比卡因,与研究1组性别、年龄、分期等资料匹配的45例(研究2组)采用20 mL 0.25%布比卡因。记录两组ESPB后2(T1)、4(T2)、8(T3)、12(T4)、24(T5)、48(T6)h时疼痛视觉模拟评分(VAS),术后24 h曲马多使用率、镇痛泵按压次数和术后24 h镇痛满意度,术后不良反应发生情况。结果:静息和咳嗽状态下两组患者VAS评分均随时间延长先升高后降低;研究1组静息状态下T2~T6、咳嗽状态下T1~T6的VAS评分均低于研究2组(P<0.05)。研究1组术后镇痛满意度评分高于研究2组(P<0.05),曲马多使用率、镇痛泵按压次数低于研究2组(P<0.05)。研究1组和2组恶心呕吐、眩晕、胸闷、瘙痒等总不良反应发生率分别为31.1%和35.6%,差异无统计学意义(P>0.05)。结论:腹腔镜胃癌根治术后30 mL 0.25%布比卡因ESPB的镇痛效果更为理想。
