超声引导下连续胸椎旁阻滞提高开腹肝切除术后患者的恢复质量：一项随机、双盲、安慰剂对照试验

崔旭蕾; 许楠; 张志永; 朱波; 张越伦; 郑永昌; 杜顺达; 毛一雷; 桑新亭; 黄宇光

doi:10.24920/003934

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超声引导下连续胸椎旁阻滞提高开腹肝切除术后患者的恢复质量：一项随机、双盲、安慰剂对照试验

中国医学科学杂志（英文版） 2022年37卷第1期页码：15-22

Original Article | Updated：2024-04-10

- 超声引导下连续胸椎旁阻滞提高开腹肝切除术后患者的恢复质量：一项随机、双盲、安慰剂对照试验
- Affiliations：
  
  1. 1Anesthesiology Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
  2. 2Central Research Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
  3. 3Hepatobiliary Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
- Author bio：
  
  *E-mail: garypumch@163.com.
- Funds：
- DOI：10.24920/003934
  中图分类号：
- 收稿日期：2021-05-14，
  
  录用日期：2021-9-28，
  
  网络出版日期：2022-03-03，
  
  纸质出版日期：2022-03-31
- Accepted：
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崔旭蕾, 许楠, 张志永, 等. 超声引导下连续胸椎旁阻滞提高开腹肝切除术后患者的恢复质量：一项随机、双盲、安慰剂对照试验[J]. 中国医学科学杂志（英文版）, 2022,37(1):15-22.

Cui Xulei, Xu Nan, Zhang Zhiyong, et al. Ultrasound-Guided Continuous Thoracic Paravertebral Block Improves Patientʼs Quality of Recovery After Open Hepatectomy: A Randomized, Double-Blind, Placebo-Controlled Trial[J]. Chinese medical sciences journal, 2022, 37(1): 15-22.
崔旭蕾, 许楠, 张志永, 等. 超声引导下连续胸椎旁阻滞提高开腹肝切除术后患者的恢复质量：一项随机、双盲、安慰剂对照试验[J]. 中国医学科学杂志（英文版）, 2022,37(1):15-22. DOI： 10.24920/003934.

Cui Xulei, Xu Nan, Zhang Zhiyong, et al. Ultrasound-Guided Continuous Thoracic Paravertebral Block Improves Patientʼs Quality of Recovery After Open Hepatectomy: A Randomized, Double-Blind, Placebo-Controlled Trial[J]. Chinese medical sciences journal, 2022, 37(1): 15-22. DOI： 10.24920/003934.

摘要

背景

超声引导下连续胸椎旁阻滞可减轻开腹肝切除术患者围术期疼痛并减少其阿片类药物用量。我们假设该效应可能改善开腹肝切除术后患者的恢复质量（quality of recovery

QoR）。

方法

76例接受开腹肝切除术的患者随机接受罗哌卡因（CTPVB组）或生理盐水（对照组）连续胸椎旁阻滞。所有患者术后均接受吗啡静脉自控镇痛48小时。主要结局是术后第7天的全维度中文版-15项QoR评分

采用Student

检验进行统计分析。

结果

CTPVB组36名患者和对照组37名患者完成了研究。与对照组相比

CTPVB组在术后第7天全维度中文版-15项QoR总分（133.14±12.97 vs. 122.62±14.89

=0.002）显著提高。CTPVB组术后疼痛评分和累积吗啡消耗量分别在8小时和48小时内显著降低（

0.05;

=0.002）。

结论

围手术期CTPVB能显著提高开腹肝切除术后患者的QoR

在术后早期可提供良好的镇痛效果。

Abstract

Background

Ultrasound-guided continuous thoracic paravertebral block can provide pain-relieving and opioid-sparing effects in patients receiving open hepatectomy. We hypothesize that these effects may improve the quality of recovery (QoR) after open hepatectomy.

Methods

Seventy-six patients undergoing open hepatectomy were randomized to receive a continuous thoracic paravertebral block with ropivacaine (CTPVB group) or normal saline (control group). All patients received patient-controlled intravenous analgesia with morphine postoperatively for 48 hours. The primary outcome was the global Chinese 15-item Quality of Recovery score on postoperative day 7

which was statistically analyzed using Student’s t-test.

Results

Thirty-six patients in the CTPVB group and 37 in the control group completed the study. Compared to the control group

the CTPVB group had significantly increased global Chinese 15-item Quality of Recovery scores (133.14 ± 12.97 vs. 122.62 ± 14.89

= 0.002) on postoperative day 7. Postoperative pain scores and cumulative morphine consumption were significantly lower for up to 8 and 48 hours (

0.05;

= 0.002)

respectively

in the CTPVB group.

Conclusion

Perioperative CTPVB markably promotes patient’s QoR after open hepatectomy with a profound analgesic effect in the early postoperative period.

关键词

Keywords

references

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