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后路腰椎减压固定术患者接受竖脊肌平面阻滞(ESPB)与经典胸椎腰椎筋膜平面阻滞(TLIP)后血清白细胞介素 6(IL-6)和白细胞介素 10(IL-10)水平的比较:一项随机对照试验。

Comparison of postoperative IL-6 and IL-10 levels following Erector Spinae Plane Block (ESPB) and classical Thoracolumbar Interfascial Plane (TLIP) block in a posterior lumbar decompression and stabilization procedure: a randomized controlled trial.

机构信息

Department of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia.

Department of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia.

出版信息

BMC Anesthesiol. 2023 Jan 10;23(1):13. doi: 10.1186/s12871-023-01973-w.

Abstract

BACKGROUND AND OBJECTIVES

The erector spinae plane block (ESPB) and classical thoracolumbar interfascial plane (TLIP) block can reduce postoperative pain in lumbar surgery. In this study, we compared the efficacy of ESPB and classical TLIP block in providing perioperative analgesia in patients undergoing lumbar posterior decompression and stabilization by comparing postoperative pain, opioid consumption, and IL-6 and IL-10 serum concentrations between ESPB and classical TLIP block.

METHOD

This was a prospective, double-blinded, randomized controlled trial in tertiary referral hospitals. Forty patients were randomized into two equal groups, each receiving either ESPB or classical TLIP block. The primary outcome was the difference in IL-6 and IL-10 serum concentrations at baseline and 6 h after lumbar posterior decompression and stabilization. The secondary outcome was total opioid consumption and pain score 24 h post-operatively.

RESULT

There were no significant differences between the ESPB and classical TLIP block groups in pain score, IL-6 and IL-10 concentration change, and total opioid consumption post-operatively. There was a significant difference in the time until the first dose of morphine was needed between the ESPB and classical TLIP block groups (300 min vs. 547.5 min; p = 0.002).

CONCLUSION

ESPB and classical TLIP block performance during lumbar surgery have comparable pain scores, IL-6 and IL-10 concentration differences pre- and post-operation, and total opioid consumption post-operatively. However, classical TLIP block provides a prolonged duration of analgesia.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04951024.

摘要

背景与目的

竖脊肌平面阻滞(ESPB)和经典的胸腰筋膜平面阻滞(TLIP)均可减轻腰椎手术的术后疼痛。在本研究中,我们通过比较 ESPB 和经典 TLIP 阻滞在接受腰椎后路减压和稳定术后的术后疼痛、阿片类药物消耗以及血清白细胞介素-6(IL-6)和白细胞介素-10(IL-10)浓度,来比较它们在提供围手术期镇痛方面的疗效。

方法

这是一项在三级转诊医院进行的前瞻性、双盲、随机对照试验。将 40 例患者随机分为两组,每组均接受 ESPB 或经典 TLIP 阻滞。主要结局是腰椎后路减压和稳定术后基础值和 6 小时时血清 IL-6 和 IL-10 浓度的差异。次要结局是术后 24 小时内的总阿片类药物消耗和疼痛评分。

结果

ESPB 和经典 TLIP 阻滞组在术后疼痛评分、IL-6 和 IL-10 浓度变化以及总阿片类药物消耗方面均无显著差异。ESPB 和经典 TLIP 阻滞组在首次需要吗啡的时间上有显著差异(300 分钟 vs. 547.5 分钟;p = 0.002)。

结论

在腰椎手术中,ESPB 和经典 TLIP 阻滞的疼痛评分、围手术期 IL-6 和 IL-10 浓度差异以及术后总阿片类药物消耗相当,但经典 TLIP 阻滞提供了更长时间的镇痛效果。

试验注册

ClinicalTrials.gov NCT04951024。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ead1/9830847/c91f56065178/12871_2023_1973_Fig1_HTML.jpg

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