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超声引导下腹横筋膜平面阻滞与竖脊肌平面阻滞对腰麻下腹股沟疝修补术患者镇痛效果的比较
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
开放式腹股沟疝修补术（OIHR）是一种常见的外科手术，目前超声引导下筋膜平面阻滞为术后多模式镇痛方案之一。本研究旨在比较竖脊肌平面阻滞（ESPB）和经髂腹股沟上腹横筋膜平面阻滞（TFPB）对接受OIHR患者术后镇痛效果的影响。
本试验为前瞻性、随机、评估者盲法的研究，在一家三级医院的术后恢复室和病房进行。共80名ASA分级为I-III的患者被研究，并平均分配到ESPB或TFPB组。除了超声引导的ESPB或TFPB外，患者还接受了标准的多模式镇痛。术后前24小时，评估曲马多的消耗量，并在术后1、3、6、9、12、18和24小时使用数字评定量表（NRS）评分比较静息和运动时的疼痛程度。
结果显示除第3小时静息NRS评分外，两组在任何时间点的NRS评分都没有差异。然而，TFPB组的曲马多消耗量总体上低于ESPB组（分别为88±75.2mg、131±93.7 mg；P=0.027，平均差异：-43，95%CI[-80.82，-5.18]）。
在接受OIHR的患者中，TFPB在术后前24小时的曲马多需求量低于ESPB。
原始文献来源：Çelik HK; Tulgar S; Bük ÖF; Koç K; Ünal M; Genç C; Süren M；Comparison of the analgesic efficacy of the ultrasound-guided transversalis fascia plane block and erector spinae plane block in patients undergoing open inguinal hernia repair under spinal anesthesia；Korean J Anesthesiol 77(2)；2024;77(2):255-264
Comparison of the analgesic efficacy of the ultrasound-guided transversalis fascia plane block and erector spinae plane block in patients undergoing open inguinal hernia repair under spinal anesthesia
Background: Open inguinal hernia repair (OIHR) surgery is a common surgical proce dure, and ultrasound guided interfascial plane blocks can also be included in current ap proaches to postoperative multimodal analgesia regimens. This study aimed to compare the postoperative analgesic efficacy of the erector spinae plane block (ESPB) and transver salis fascia plane block (TFPB) in patients undergoing OIHR.
Methods: This prospective, randomized, assessor-blinded comparative study was con ducted in the postoperative recovery room and ward of a tertiary hospital. A total of 80 patients with American Society of Anesthesiologists physical status I–III were enrolled and allocated equally to either the ESPB or TFPB group. The patients received standard multi modal analgesia in addition to an ultrasound-guided ESPB or TFPB. During the first 24 h postoperatively, tramadol consumption was assessed and pain levels at rest and during movement were compared using numeric rating scale (NRS) scores at 1, 3, 6, 9, 12, 18, and 24 h postoperatively.
Results: The results showed no difference in NRS scores at any time point between the groups, except for NRS at rest in the third hour. However, tramadol consumption was low er in the TFPB group than in the ESPB group overall (88 ± 75.2 vs. 131 ± 93.7 mg, respec tively; P = 0.027, mean difference: −43, 95% CI [−80.82, −5.18]). Conclusions: The TFPB leads to lower tramadol requirements in the first 24 h postopera tively than the ESPB in patients undergoing OIHR.
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