Gao Jingchun,Ren Yi,Zheng Tiehua,et al.Efficacy of erector spinae plane block on postoperative recovery in adolescent idiopathic scoliosis children undergoing posterior spinal fusion surgery[J].Journal of Clinical Pediatric Surgery,2024,(05):446-451.[doi:10.3760/cma.j.cn101785-202309052-009]
超声引导下竖脊肌平面阻滞对脊柱侧弯患儿术后早期康复质量的影响
- Title:
- Efficacy of erector spinae plane block on postoperative recovery in adolescent idiopathic scoliosis children undergoing posterior spinal fusion surgery
- Keywords:
- Erector Spinae Plane Block; Scoliosis; Postoperative Recovery; Surgical Procedures; Operative; Child
- 摘要:
- 目的 探讨超声引导下竖脊肌平面阻滞(erector spinae plane block,ESPB)对青少年特发性脊柱侧弯(adolescent idiopathic scoliosis,AIS)患儿行后路脊柱融合(posterior spine fusion,PSF)术后早期恢复的影响。 方法 本研究为前瞻性研究,选取首都医科大学附属北京儿童医院择期行PSF手术的50例患儿作为研究对象,采用随机数表法分为ESPB组和对照组(C组),每组25例。记录患儿术前和术后24 h康复质量(quality of recovery,QoR)-15评分、术后24 h疼痛评分、镇痛药物用量、首次下床活动时间以及进食、进水时间。 结果 两组一般情况和术前QoR-15评分差异均无统计学意义(P>0.05)。ESPB组和C组术后24 h QoR-15评分分别为(110.5±12.3)分和(99.0±13.6)分,ESPB组显著高于C组(P=0.003)。两组术后麻醉恢复室停留时间[ESPB组(18.6±4.5) min比C组(25.1±7.4) min,P<0.001]、首次下床活动时间[ESPB组(38.8±5.2) h比C组(43.6±5.3) h,P=0.002]、饮水时间[ESPB组2(1,2) h比C组2(2,4) h,P<0.001]和进食时间[ESPB组(12.6±4.5) h比C组(18.1±5.5) h,P<0.001]差异均有统计学意义。ESPB组患儿术后24 h疼痛评分曲线下面积(59.6±12.1)显著高于C组(81.7±10.8),差异有统计学意义(P< 0.001);ESPB组和C组患儿术后第1日镇痛泵按压次数分别为(18.1±5.5)次和(25.4±6.7)次,补救镇痛药物地佐辛用量分别为4.5(3.0,6.0) mg和6.0(4.5,10.0) mg,差异均有统计学意义(P<0.05)。两组患儿术后并发症和住院时长差异无统计学意义(P>0.05)。 结论 ESPB用于PSF患儿可缓解术后疼痛,提高术后早期康复质量。
- Abstract:
- Objective To explore the effect of ultrasound-guided erector spinae plane block (ESPB) on postoperative recovery for adolescent idiopathic scoliosis (AIS) children undergoing posterior spine fusion (PSF) surgery.Methods Fifty patients undergoing elective PSF were randomized into two groups of ESPB (n=25) and control (n=25).Quality of recovery (QoR)-15 score at preoperative and postoperative 24h,numerical rating scale (NRS),analgesic dose,mobilization time,discharge time and side effects were evaluated.Results No significant difference existed in baseline profiles or preoperative quality of recovery (QoR)-15 score.At postoperative 24 h,QoR-15 was significantly higher in group E than that in group C [(110.5±12.3) vs.(99.0±13.6),P=0.003].Postoperative anesthesia care unit (PACU) stay was significantly shorter in ESPB group than in control group [(18.6±4.5) vs.(25.1±7.4) min,P<0.001].As compared with control group,early mobilization [(38.8±5.2) vs.(43.6±5.3) h,P=0.002],drinking [2(1,2) vs.2(2,4) h,P<0.001]and ingesting [(12.6±4.5) vs.(18.1±5.5) h,P<0.001]were better in ESPB group.The area under the curve (AUC) of NRS score over postoperative 24 h was significantly lower in ESPB group than that in control group [(59.6±12.1) vs.(81.7±10.8),P<0.001].At postoperative 24 h,opioid consumption as measured by parent-controlled intravenous analgesia (PCIA) boluses and necessity of rescue analgesia was lower in ESPB group than that in control group [(18.1±5.5) vs.(25.4±6.7),P<0.010;4.5(3.0,6.0) vs. 6.0(4.5,10.0) mg,P<0.009].No statistically significant difference existed in length of hospitalization stay or side effects.Conclusions ESPB is adequate for postoperative analgesia in AIS children undergoing spine surgery.It improves postoperative recovery.
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备注/Memo
收稿日期:2023-09-28。
基金项目:深圳市“医疗卫生三名工程”(SZSM202011012); 吴阶平医学基金会临床科研专项资助基金(320.6750.19089—102)
通讯作者:郭东,Email:dr.guodong@vip.163.com