RegionalAnalgesiaforLaparoscopicCholecystectomyUsingUltrasound-guidedQuadratusLumborumBlockorErectorSpinaeBlock:ARandomizedControlledTrial
超声引导腰方肌阻滞或竖脊肌阻滞进行腹腔镜胆囊切除术的区域镇痛：一项随机对照试验
论文摘要
Background:Postoperativepainincreasestheincidenceofvenousthrombosisandrespiratorycomplications,preventsearlypostoperativeambulation,andprolongshospitalstay.Fascialplaneinjectionssuchaserectorspinaeplane(ESP)blockandquadratuslumborum(QL)blocksarepopularmethodsforpostoperativepaincontrolandreducingopioidconsumption.
背景：
Objectives:Weaimedtoevaluatetheanalgesiceffectsofultrasound-guidedESPversusQLblockduringlaparoscopiccholecystectomyforthereductionofpainandanalgesicconsumption.
目的：
我们旨在评估腹腔镜胆囊切除术中超声引导ESP与QL阻滞的镇痛效果，以减少疼痛和镇痛药消耗。
StudyDesign:Prospective,double-blind,single-center,randomizedcontrolledclinicaltrial.
研究设计：
前瞻性、双盲、单中心、随机对照临床试验。
Setting:MiniaUniversityHospital,MiniaGovernorate,Egypt.
地点：
埃及米尼亚省米尼亚大学医院。
Methods:PatientsscheduledforlaparoscopiccholecystectomyfromApril2019throughDecember2019wererandomlyallocatedinto3groups.Afterinductionofgeneralanesthesia,GroupAreceivedanESPblock,groupBreceivedaQLblock,andgroupCdidn’treceiveanyblock(control).Themainoutcomewasthetimetothefirstanalgesicrequest.SecondaryoutcomeswerethepainintensitymeasuredbytheVisualAnalogScaleatone,2,4,6,8,12,16,20,and24hourspostoperativelyatrestandcough.Thetotalanalgesicrequirementduringthefirst24postoperativehours,hemodynamics,andanycomplicationswererecorded.
方法：
Results:Sixtypatientsscheduledforelectivelaparoscopiccholecystectomywereenrolled;theclinicalanddemographicdataweresimilarinthe3groups.GroupsAandBhadlowerVASscoresatcoughthanGroupCinthefirstpostoperative2hours.ComparedtoGroupC,ahigherscorewasreportedat8,12,and16hoursinGroupA,andat8and16hoursinGroupB.GroupBhadahigherscoreat4hoursthanGroupA.Atrest,GroupCshowedhigherscoresthanGroupsAandBinthefirst2hours,whilehigherscoreswerenotedat16hoursinGroupAand12hoursinGroupB.TimetofirstrequestofanalgesiawassignificantlyprolongedinGroupAthaninGroupsBandC(P<0.001).OurstudyshowedthatGroupsAandBhadlowerpostoperativeanalgesicrequirementsthanGroupC(P<0.05).
结果：
Limitations:Thisstudyhadasmallnumberofpatientsenrolled.
Conclusions:BothESPandQLblockseffectivelyreducedVASscoresatbothcoughandrest.Therewasadecreasedtotalconsumptionofanalgesicsinthefirstpostoperative24hourswithalongerdurationofanalgesia,whichlasted16hoursintheESPgroupand12hoursintheQLgroup.
结论：
结果展示
PrimaryandSecondaryOutcomes
1.Thetimetothefirstanalgesicrequest(Fig.2)wassignificantlylongerinGroupA(13.5±4.5h)thaninGroupsB(8.7±4.1h)andC(1.3±0.4h)(P<0.001).
2.ThedurationofanalgesiawasshorterinGroupC(1.3±0.4h)whencomparedwithGroupA(11.2±2h)andGroupB(10.0±3.4)(P<0.001).
3.PostoperativefentanylrequirementwashigheringroupC(98.9±34.1μg/kg)thanGroupA(79.5±21.2)andGroupB(83±19.6)with(P=0.04).
C组术后芬太尼需要量高于A组和B组（P=0.04）。
4.PatientsinGroupsAandBhadsignificantlylowerVASscoresatcoughthanGroupCatpostoperativehoursoneandtwo,whileGroupBshowedhigherVASscoresthanGroupCatpostoperativehours8,12,and16.GroupAshowedhigherVASscoresatpostoperativehours8and16.Atpostoperativehour4,GroupBhadasignificantlyhigherVASscorethanGroupA.
术后第1h和第2h，A组和B组患者咳嗽时VAS评分显着低于C组，而B组患者在术后第8、12和16hVAS评分高于C组。A组在术后8h和16h表现出较高的VAS评分。术后4h，B组的VAS评分显着高于A组。
5.Atrest,GroupCshowedhigherVASscoresthanGroupsAandBatpostoperativehoursoneand2.GroupBhadahigherVASscorethanGroupAatpostoperative12hours,whileGroupA’sVASscorewashigheratpostoperativehour16.
静息状态下，C组在术后1h和2h的VAS评分高于A组和B组。B组在术后12h的VAS评分高于A组，而A组在术后16h的VAS评分较高。
排版：肉肉
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