Bilateral single-injection erector spinae plane block versus intrathecal morphine for postoperative analgesia in living donor laparoscopic hepatectomy: a randomized non-inferiority trial

医学 罗哌卡因 麻醉 呕吐 恶心 术后恶心呕吐 随机对照试验 止痛药 吗啡 肝切除术 外科 切除术
作者
RyungA Kang,Ki Jinn Chin,Mi Sook Gwak,Gaab Soo Kim,Soo Joo Choi,Jong Man Kim,Gyu‐Seong Choi,Justin Sangwook Ko
出处
期刊:Regional Anesthesia and Pain Medicine [BMJ]
卷期号:: rapm-100902 被引量:41
标识
DOI:10.1136/rapm-2019-100902
摘要

Background Intrathecal morphine (ITM) provides effective postoperative analgesia in living donor hepatectomy but has significant adverse effects. Studies support the efficacy of erector spinae plane (ESP) blocks in laparoscopic abdominal surgery; we therefore hypothesized that they would provide non-inferior postoperative analgesia compared with ITM and reduce postoperative nausea/vomiting and pruritus. We conducted a randomized, controlled, non-inferiority trial to compare the analgesic efficacy of ITM and bilateral single-injection ESP blocks in laparoscopic donor hepatectomy. Methods Fifty-four donors were randomized to receive bilateral ESP blocks with 20 mL 0.5% ropivacaine (n=27) or 400 µg ITM (n=27). Primary outcome was resting pain score 24 hours postoperatively measured on an 11-point numeric rating scale. The prespecified non-inferiority limit was 1. Incidences of postoperative nausea/vomiting and pruritus were assessed. Results The mean treatment difference (ESP–ITM) in the primary outcome was 1.2 (95% CI 0.7 to 1.8). The 95% CI upper limit exceeded the non-inferiority limit. Opioid consumption and all other pain measurements were similar between groups up to 72 hours postoperatively. The ESP group had significantly lower incidences of postoperative vomiting (p=0.002) and pruritus (p<0.001). Conclusions Bilateral single-injection ESP blocks resulted in higher resting pain scores 24 hours postoperatively compared with ITM and thus did not meet the study definition of non-inferiority. However, the pain intensity with ESP blocks was mild (mean pain scores <3/10) and associated with reduced incidence of postoperative vomiting and pruritus. It warrants further investigation as an analgesic option after laparoscopic living donor hepatectomy. Trial registration number KCT0003191.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
lilili完成签到,获得积分10
1秒前
1秒前
1秒前
暖晴发布了新的文献求助10
1秒前
2秒前
wen发布了新的文献求助200
2秒前
dudu发布了新的文献求助10
3秒前
留胡子的云朵完成签到,获得积分10
3秒前
3秒前
臭小子发布了新的文献求助10
3秒前
xbx1991发布了新的文献求助10
3秒前
4秒前
4秒前
梓榆发布了新的文献求助10
4秒前
甘草三七发布了新的文献求助10
4秒前
Jasen发布了新的文献求助30
4秒前
dd发布了新的文献求助10
5秒前
过柱菜鸟发布了新的文献求助10
5秒前
6秒前
Nn完成签到 ,获得积分10
6秒前
6秒前
queen814发布了新的文献求助10
7秒前
7秒前
科研完成签到,获得积分10
7秒前
善学以致用应助张雨兴采纳,获得10
7秒前
8秒前
见青山发布了新的文献求助10
8秒前
LY完成签到,获得积分10
8秒前
慕明花开完成签到,获得积分10
8秒前
乐乐应助嘿嘿采纳,获得10
9秒前
甘草三七完成签到,获得积分10
9秒前
小马甲应助臭小子采纳,获得10
10秒前
打打应助toking采纳,获得10
11秒前
11秒前
传奇3应助共情采纳,获得10
11秒前
CodeCraft应助陌路孤星采纳,获得10
11秒前
甜美剑愁发布了新的文献求助10
11秒前
11秒前
JamesPei应助研友_Z1WrgL采纳,获得10
11秒前
12秒前
高分求助中
Picture Books with Same-sex Parented Families: Unintentional Censorship 700
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
Nucleophilic substitution in azasydnone-modified dinitroanisoles 500
不知道标题是什么 500
Indomethacinのヒトにおける経皮吸収 400
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 370
Effective Learning and Mental Wellbeing 300
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3974358
求助须知:如何正确求助?哪些是违规求助? 3518706
关于积分的说明 11195521
捐赠科研通 3254897
什么是DOI,文献DOI怎么找? 1797614
邀请新用户注册赠送积分活动 877011
科研通“疑难数据库(出版商)”最低求助积分说明 806128