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竖脊肌平面阻滞对髋关节发育不良手术患儿术后镇痛的效果：一项随机对照双盲研究
贵州医科大学 麻醉与心脏电生理课题组
翻译：王贵龙 编辑：杨荣峰 审校：曹莹
髋关节发育不良（DDH）的开放手术可能会因肌腱切开和骨盆股骨截骨术而引起剧烈疼痛。本研究旨在评估超声引导下竖脊肌平面阻滞（L-ESP）对接受DDH手术患儿的镇痛效果。
60名择期进行DDH手术的患儿被随机分为两组。L-ESP组（n=30）在手术前接受L-ESP（0.25%布比卡因、0.5 mL/kg ），对照组（n=30）接受相同体积的生理盐水注射。两组均采用相同的术后镇痛方案。记录父母满意度、疼痛程度、布洛芬和阿片类药物的摄入量。采用FLACC量表（面部、腿部、活动、哭泣、舒适度）评估疼痛程度。
L-ESP组在术后早期24小时的FLACC评分低于对照组（p<0.001）。对照组的阿片类药物使用率（15/26）高于L-ESP组（2/29）（p<0.001）。在病房中，对照组的布洛芬使用率高于L-ESP组（分别为24/26和3/29，p<0.001）。L-ESP组患儿的父母满意度更高（p=0.024）。
超声引导下的L-ESP是一种有效的区域麻醉技术，可为DDH手术患儿提供良好的术后镇痛。
原始文献来源：Hilal, Cirak; Ali, Ahiskalioglu; Elif Oral, Ahiskalioglu; Kubra, Yazici; Ahmet Murat, Yayik; Postoperative analgesic effect of lumbar erector spinae plane block for developmental hip dysplasia surgery: a randomized controlled double-blind study；Sci Rep 2024 Nov 6;14(1):26917；DOI：10.1038/s41598-024-75390-5；PMID：39505882
Postoperative analgesic effect of lumbar erector spinae plane block for developmental hip dysplasia surgery: a randomized controlled double-blind study
Abstract
Open surgery for developmental dysplasia of the hip (DDH) may cause severe pain due to tenotomies and pelvic-femoral osteotomies. This study aims to evaluate the analgesic effect of ultrasound-guided Lumbar Erector Spina Plane (L-ESP) Block in pediatric patients undergoing DDH surgery. Sixty children scheduled for DDH surgery were randomly assigned into two groups. Group I (n = 30) received L-ESP with 0.5 mL/kg of 0.25% bupivacaine before surgery. In contrast, Group II (n = 30), as the control group, received the same volume of saline injection. Identical postoperative analgesia protocol was adjusted for both groups. Parental satisfaction, pain levels, ibuprofen, and opioid consumption were recorded. Pain levels were evaluated with the FLACC (Face, Legs, Activity, Crying, Consolability) scale. FLACC scores at the first 24th hours were lower in the L-ESP group than the control group (p < 0.001). Rescue opioid utilization was higher in the control group (15/26) than in the L-ESP group (2/29) (p < 0.001). The consumption of ibuprofen was higher in the control group than in the L-ESP group in the ward (24/26 vs. 3/29, p < 0.001, respectively). Parental satisfaction was superior in the L-ESP group (p = 0.024). To provide postoperative analgesia for DDH surgery, ultrasound-guided L-ESP may be an effective and alternative regional anesthetic technique.
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