前鋸肌肋間筋膜間平面阻滯在上腹部手術(shù)中的應(yīng)用:一項(xiàng)前瞻性隨機(jī)對照試驗(yàn)
貴州醫(yī)科大學(xué) 麻醉與心臟電生理課題組
翻譯：李奕
結(jié)果：
本研究顯示，0組（SIPB）術(shù)后24小時(shí)阿片類藥物消耗量較低（P<0.0001；4.17 mg vs.41.52 mg嗎啡），疼痛控制較好（P<0.005），平均疼痛評分（NVs 1.8±1.5 vs.4.8±0.6）。SIPB組術(shù)后24小時(shí)的總體QoR-15評分更高（質(zhì)量更好）（122vs.100）。
低位前鋸肌-肋間筋膜間平面阻滯（SIPB）提供了有效的鎮(zhèn)痛作用，從而節(jié)省阿片類藥物，提高上腹部手術(shù)患者的恢復(fù)質(zhì)量。
原始文獻(xiàn)來源：
María T Fernández , Servando López , Jose A Aguirre, et al. Serratus intercostal interfascial plane block in supraumbilical surgery: a prospective randomized comparison.[J].Minerva Anestesiol. 2021 Feb;87(2):165-173.
Serratus intercostal interfascial plane block in supraumbilical surgery: a prospective randomized comparison
Abstract
Background: Upper abdominal wall surgical incisions may lead to a severe postoperative pain. Therefore, adequate analgesia is important. Here we investigate whether the low serratus-intercostal interfascial plane block (SIPB) achieves an effective analgesia, considering opioids consumption, pain control and recovery quality in upper abdominal surgeries.
Method:This blinded, randomized controlled study was conducted on 102 patients undergoing open upper abdominal wall surgery under general anesthesia. All patients who received serratus-intercostal plane block at the eighth rib as analgesic technique were included in SIPB group and in control group those who received continuous intravenous morphine analgesia. Pain scores in numeric verbal scale (NVS) and opioids consumption at 0, 6, 12, 24 and 48 hours postoperatively were assessed. The quality of the postoperative recovery was evaluated using the QoR-15 questionnaire at 24 hours.
Results:This study showed lower postoperative opioid consumption at 24 hours (P<0.0001; 4.17 mg vs. 41.52 mg of morphine) and better pain control (P<0.005) with mean pain scores (NVS 1.8±1.5 vs. 4.8±1.6) in group 0 (SIPB). The global QoR-15 scores 24 hours postoperatively were higher (better quality) in the SIPB group (122 vs. 100).
Conclusion:The low serratus-intercostal interfascial plane block (SIPB) provides efficient analgesia leading to a saving of opioids and improvement of the recovery quality in patients undergoing upper abdominal wall surgeries.
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