Background

Laparoscopic cholecystectomy is a common surgical procedure that frequently results in substantial postoperative pain. Erector spinae plane block (ESPB) has been shown to have beneficial postoperative analgesic effects when used as a part of multimodal analgesia. The aim of this study was to determine whether ESPB improves postoperative recovery quality in patients undergoing laparoscopic cholecystectomy. Evaluation of the effects of ESPB on postoperative pain, opioid consumption, and nausea and vomiting was the secondary objective.

Methods

In this prospective double-blind study, 82 patients undergoing laparoscopic cholecystectomy were randomised into one of two groups: a standard multimodal analgesic regimen in Group N (control) or an ESPB was performed in Group E. Preoperative and postoperative recovery quality was measured using the 40-item quality of recovery (QoR-40) questionnaire; postoperative pain was evaluated using the numerical rating scale scores.

Results

Postoperative mean (standard deviation) QoR-40 scores were higher in Group E (181 [7.3]) than in Group N (167 [11.4]); P<0.01. With repeated measures, a significant effect of group and time was demonstrated for the global QoR-40 score, P<0.01, indicating better quality of recovery in Group E. Pain scores were significantly lower in Group E than in Group N, both during resting and motion at T1–T8 times (P<0.01 at each time). The total amount of tramadol consumed in the first 24 h was lower in Group E [median 0 mg, inter-quartile range (IQR) (0–140)], than in Group N [median 180 mg, IQR (150–240); P<0.01].

Conclusions

ESPB improved postoperative quality of recovery in patients undergoing laparoscopic cholecystectomy. Moreover, ESPB reduced pain scores and cumulative opioid consumption.

Clinical trial registration

NCT04112394.

中文翻译：

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竖脊肌平面阻滞对腹腔镜胆囊切除术后恢复质量的影响：一项前瞻性双盲研究

背景

腹腔镜胆囊切除术是一种常见的外科手术，经常导致术后疼痛。当用作多模式镇痛的一部分时，竖脊肌平面阻滞 (ESPB) 已被证明具有有益的术后镇痛效果。本研究的目的是确定 ESPB 是否能提高腹腔镜胆囊切除术患者的术后恢复质量。评估 ESPB 对术后疼痛、阿片类药物消耗、恶心和呕吐的影响是次要目标。

方法

在这项前瞻性双盲研究中，82 名接受腹腔镜胆囊切除术的患者被随机分为两组：N 组（对照）中的标准多模式镇痛方案或 E 组中进行 ESPB。术前和术后恢复质量使用40 项恢复质量 (QoR-40) 问卷；使用数字评定量表评分评估术后疼痛。

结果

E组术后平均（标准差）QoR-40评分（181 [7.3]）高于N组（167 [11.4]）；P <0.01。通过重复测量，组和时间对整体 QoR-40 评分有显着影响，P <0.01，表明 E 组的恢复质量更好。E 组的疼痛评分显着低于 N 组，无论是在休息期间并在 T1-T8 次运动（每次P <0.01）。E 组前 24 小时消耗的曲马多总量 [中位数 0 mg，四分位间距 (IQR) (0-140)] 低于 N 组 [中位数 180 mg，IQR (150-240) ; P <0.01]。

结论

ESPB 提高了腹腔镜胆囊切除术患者的术后恢复质量。此外，ESPB 降低了疼痛评分和累积的阿片类药物消耗量。

临床试验注册

NCT04112394。