Effects Of Ultrasound-guided Erector Spinae Plane Block For Postoperative Pain In Open Hepatectomy Surgery

Objective:To evaluate the efficacy of preoperative ultrasound-guided Erectile Spine Plane block(ESP)combined with Patient-Controlled Intravenous Analgesia(PCIA)for patients postoperative with pain undergoing open hepatectomy sex.Methods:Select 60 patients undergoing partial hepatectomy under general anesthesia,33males and 27 females,ASA I-II grade,age 18-80 years,BMI 18-30 kg/m2,liver function Child-push grade A or B Grade,ethical,patient voluntary,signed informed consent.Randomized digital table method was used to divide into two groups randomly:ESP block group(E group)and control group(C group),30 cases in each group.In E group,according to the guidance of ultrasound,each side was given 20ml of ropivacaine 0.5%for erector spine muscle Plane block after induction of anesthesia,both sides 40ml in total;C group did not block.Both patients were given Patient-Controlled Intravenous Analgesia(PCIA)at the same time after surgery.Observing the immediate time before skin incision in two groups,heart rate(HR)in5min after cutting and mean arterial pressure(MAP),and recorded the difference of~?MAP and~?HR(before incision-after skin incision).The total amount of intraoperative sufentanil,total amount of postoperative sufentanil,intraoperative fluid volume,intraoperative blood loss and operative time were recorded.Follow-up and recorded Visual Analogue Scale(VAS)values in resting and movement period at2h,4h,8h,24h and 48h after operation and recorded the time of initial compression of analgesic pump,effective times of compressions of analgesic pump in 48 hours after surgery,rate of additional analgesic remediation and satisfaction rating of analgesia;the first anus exhaust time,first ambulation time,length of hospital stay and postoperative dizziness,nausea and vomiting,incision infection and other adverse reactions.Results:The immediate time before skin incision,5min,MAP and HR of E group were significantly lower than those of C group(P<0.05).Compared with C group,the total amount of intraoperative sufentanil and the total amount of postoperative sufentanil in E group was significant decrease(P<0.05).There was no significant difference in intraoperative fluid volume,intraoperative blood loss and operation time between this two groups(P>0.05);The VAS scores decreased significantly at 2h,4h,8h and 24h rest and movement in E group after operation(P<0.05).There was no significant difference in VAS scores between this two groups at 48 hours rest and movement after surgery(P>0.05).The time for the first compression in the E group was significantly later than that in the C group(P<0.05);Compared with C group,the number of effective compression of PCIA and the recovery rate of additional pain medication were significantly reduced in E group within 48 hours after operation(P<0.05),and the degree of satisfaction with analgesia was significantly higher in E group(P<0.05).The time of secondary anus exhaust and the time of first ambulation in E group were significantly earlier than those in C group(P<0.05),the length of hospital stay was significantly shorter(P<0.05).Compared with C group,the incidence of postoperative nausea,vomiting and dizziness was significantly reduced in E group.(P<0.05),there was no significant difference in incision infection rate(P>0.05).Conclusion:Preoperative ultrasound-guided single bilateral erectus spinal plane block can significantly reduce the perioperative opioid use in patients undergoing open hepatic excision.At the same time,the time for getting out of bed can be significantly advanced,and the length of hospital stay can be shortened,the incidence of the reaction was reduced,and the satisfaction and comfort of the postoperative analgesia effect were improved.