Effects of ultrasound-guided erector spine plane block on postoperative analgesia in elderly patients undergoing abdominal operation / 中华老年医学杂志

ABSTRACT

Objective:To investigate the effect of ultrasound-guided erector spine plane block(ESPB)on postoperative analgesia in elderly patients undergoing abdominal operation.Methods:This was a prospective study.A total of 50 patients undergoing cholecystectomy and choledochotomy under laparotomy and general anesthesia were divided into two groups(n=25, each)according to the random number table method.The patient-controlled intravenous analgesia was named as the group P, and a single ESPB(the group E)was conducted with 0.33% ropivacaine 30 ml before induction of anesthesia as add-on to the management of group P. The block rang of ESPB, visual analogue scale(VAS)at 4, 12, 24 h postoperatively, number of analgesia pump pressure, number of patients receiving parecoxib sodium medication, complications related to the ESPB including dyspnea and local anesthetic systemic toxicity and anal exhaust time were recorded in the two groups.Results:The range of pain block in group E included the spinal innervation area(T5~T12)(13 cases)and(T6~L1)(12 cases). Compared with the group P, the group E showed that EVAS scores at 4, 12, 24 h postoperatively were decreased(4.2±1.1 vs.1.4±0.6, 4.0±0.8 vs.1.8±1.2, 3.5±0.9 vs.2.0±1.1, P<0.01), the number of analgesia pump pressure and the number of patients receiving supplemental parecoxib sodium were decreased(2.5±0.9 vs.9.9±1.5, 20.0% or 5 cases vs.64.0% or 16 cases, t=10.566, χ2=9.934, P<0.01), and the anal exhaust time was shortened[(20.1±1.9)h vs.(24.5±2.1)h, t=7.388, P<0.01]. No patients had dyspnea or local anesthetic toxicity. Conclusions:Ultrasound-guided ESPB has less complications, lower dose of postoperative opioid analgesics, faster recovery of postoperative intestinal function.