Comparative study on post-operational analgesia by erector spinae plane block or by transversus abdominis plane block in patients with intrahepatic lithiasis undergoing laparoscopic hepatic lobectomy
Objective The aim of this study was to compare post-operational analgesia by erector spinae plane block(ESPB)or by transversus abdominis plane block(TAPB)in patients with intrahepatic lithiasis undergoing laparoscopic hepatic lobectomy.Methods 94 patients with intrahepatic bile duct stones were enrolled in our hospital between October 2021 and October 2023,and all patients underwent laparoscopic hepatic lobectomy.For post-operational analgesia,47 patients were assigned to receive ESPB under ultrasound(US)guidance and another 47 patients to receive TAPB under US guidance.Visual analogue scale(VAS)and Ramsay sedation score scale were applied to assess the postoperative analgesia and sedation.Serum cortsisol(Cor),norepinephrine(Ne)and epinephrine(E)levels were detected by ELISA.Results At 6 hours,12 hours and 24 hours after surgery,VAS scores in patients receiving ESPB were(3.1±0.6)points,(3.3±0.7)points and(3.2±0.6)points,all significantly lower than[(3.8±0.7)points,(4.1±0.7)points and(3.9±0.8)points,P＜0.05]in patients receiving TAPB;at 48hours after operation,serum Cor,Ne and E levels were(264.2±29.7)pg/ml,(2.8±0.6)pg/nil and(203.9±26.8)pg/ml,all significantly lower than[(306.3±33.2)pg/ml,(3.5±0.8)pg/ml and(257.8±32.3)pg/ml,respectively,P＜0.05]in those receiving TAPB;analgesic pump compressions was(4.8±1.3)times,much less than[(6.1±1.8)times,P＜0.05]in patients receiving TAPB;incidence of adverse events were 14.9％vs.17.0％,not statistically different between the two groups(P＞0.05).ConclusionIn patients with intrahepatic lithiasis undergoing laparoscopic hepatic lobectomy,ultrasound-guided ESPB could achieve a satisfactory analgesia post-operationally,which might relieve bodystress reactions.
万方数据
维普
