竖脊肌平面阻滞在腹部手术中的临床应用进展

Progress of Clinical Application of Erector Spinal Plane Block in Abdominal Surgery

摘要: 竖脊肌平面阻滞(erector spinae plane block, ESPB)作为一种新兴的区域阻滞技术，在腹部手术围术期镇痛管理中展现出广泛的应用前景。其通过在竖脊肌筋膜下注射局麻药，阻滞多条脊神经后支，从而实现有效的术后镇痛，减少全身麻醉药物和阿片类药物的使用，提高患者的术后舒适度。近年来，相关研究表明，ESPB具有操作简单、安全性高、并发症少的特点，尤其在腹腔镜手术、剖腹手术以及复杂肝胆胰手术中，均取得了显著的镇痛效果。然而，不同的药物选择、注射方式及阻滞范围对其效果的影响仍需进一步探索。本综述旨在总结ESPB在腹部手术中的临床研究进展，分析其优缺点及适应症，为临床应用提供参考。

Abstract: Erector spinae plane block (ESPB), as a new regional block technique, has a wide potential for application in perioperative analgesia management of abdominal surgery. Through subfascial injection of local anesthetics into the erector spinal muscle, multiple posterior branches of spinal nerves are blocked, thus achieving effective postoperative analgesia, reducing the use of general anesthesia drugs and opioids, and improving the postoperative comfort of patients. In recent years, relevant studies have shown that ESPB has the characteristics of simple operation, high safety and few complications, especially in laparoscopic surgery, laparotomy and complex hepatobiliary and pancreatic surgery, and has achieved significant analgesic effects. However, the effects of different drug selection, injection mode and block range on its efficacy still need to be further explored. The purpose of this review is to summarize the clinical research progress of ESPB in abdominal surgery, analyze its advantages and disadvantages and indications, and provide a reference for clinical application.