竖脊肌平面阻滞对腹腔镜肾癌术后患者持续性疼痛的影响

Effect of Erector Spinae Plane Block on Persistent Pain of Patients after Laparoscop-ic Renal Carcinoma Surgery

摘要: 目的：观察竖脊肌平面阻滞(ESPB)在预防腹腔镜肾癌术后患者的持续性疼痛的作用。方法：选择2022年5月12日至2022年12月31日在我院拟行腹腔肾部分切除术和腹腔镜根治性肾切除术患者120例。采用随机数字表法将患者随机分为两组：竖脊肌平面阻滞(ESPB)组(E组，n = 60)和对照组(C组，n = 60)。E组全麻诱导前行超声引导下手术侧T10平面竖脊肌平面阻滞，给予0.33%罗哌卡因30 ml；C组行单纯全麻。两组全麻方案相同。记录两组患者手术时间，术后6 h (T₁)、12 h (T₂)、24 h (T₃)、48 h (T₄)、1周(T₅)、一个月(T₆)、3个月(T₇)的疼痛数字评定量表(NRS)，对比两组术后1个月、3个月手术切口神经病理性疼痛发生率、整体疼痛评估量表(GPS)评分。结果：E组术后T₁、T₂、T₃、T₄、T₅、T₆、T₇的NRS评分明显低于C组(P < 0.05)，E组和C组手术切口神经病理性疼痛发生率无明显差异，E组的1个月、3个月的GPS评分较C组低(P < 0.05)。结论：竖脊肌平面阻滞能减少患者手术后急性疼痛，并能减少术后持续性疼痛的发生，改善患者术后整体生活质量。

Abstract: Objective: To observe the role of erector spinae plane block (ESPB) in preventing persistent pain in patients with laparoscopic renal cell carcinoma. Methods: From May 12, 2022 to December 31, 2022, 120 patients were chosen to undergo partial abdominal nephrectomy and laparoscopic radical ne-phrectomy at our hospital. The patients were randomly assigned to two groups: the ESPB group (E group, n = 60) and the control group (C group, n = 60). Before induction of general anesthesia, the patients in group E received the ultrasound-guide erector spinae plane block with 30 ml of 0.33% ropivacaine on the surgical side of T10. Group C was given general anesthesia. The two groups’ gen-eral anesthesia plans are identical. The operation time, as well as the pain digital rating scale (NRS) at 6 hours (T₁), 12 hours (T₂), 24 hours (T₃), 48 hours (T₄), 1 week (T₅), 1 month (T₆), and 3 months (T₇) after the operation, were recorded. At 1 month and 3 months after surgery, the incidence of neuropathic pain and the global pain assessment scale (GPS) score were compared between the two groups. Results: The NRS score of T₁, T₂, T₃, T₄, T₅, T₆, T₇ in Group E was significantly lower than that in Group C (P < 0.05), there was no significant difference in the incidence of neuropathic pain be-tween Group E and Group C. and the GPS score of 1 month and 3 months in Group E was lower than that in Group C (P < 0.05) . Conclusions: ESPB can reduce acute postoperative pain, as well as the occurrence of persistent postoperative pain, and improve patients’ overall quality of life.