竖脊肌平面阻滞在腹部手术中的研究进展

Research Progress of Erector Spinae Plane Block in Abdominal Surgery

摘要: ESPB作为一种新型的区域麻醉技术，通过将局麻药注射至竖脊肌深面与横突之间的筋膜平面内，为腹部手术提供了有效的术后镇痛。本文介绍了ESPB的解剖学基础与作用机制，包括筋膜扩散理论、椎旁间隙扩散假说和交感神经抑制假说等。同时，探讨了ESPB在胃肠手术、妇产科手术和泌尿外科手术中的应用进展，以及其在不同手术类型中的技术优化和药物选择。研究表明，ESPB可有效减少术后阿片类药物的使用，降低术后恶心呕吐等并发症的发生率，提高患者满意度。然而，目前关于ESPB的随机对照试验研究样本量偏少，仍需进一步扩大样本量进行验证。

Abstract: ESPB, as a novel regional anesthesia technique, provides effective postoperative analgesia for abdominal surgery by injecting local anesthetics into the fascial plane between the deep surface of the erector spinae muscle and the transverse process. This paper introduces the anatomical basis and mechanism of action of ESPB, including fascial plane diffusion theory, paravertebral space penetration hypothesis, and sympathetic chain inhibition hypothesis. Additionally, it explores the application progress of ESPB in gastrointestinal surgery, obstetric and gynecological surgery, and urological surgery, as well as its technical optimization and drug selection in different surgical types. Research has shown that ESPB can effectively reduce the use of postoperative opioids, decrease the incidence of complications such as postoperative nausea and vomiting, and improve patient satisfaction. However, current randomized controlled trials on ESPB have relatively small sample sizes, and further validation with larger sample sizes is needed.