Application Of Ultrasound-guided Erector Spinae Plane Block In Laparoscopic Nephrectomy

Objective: Based on the ERAS concept,this paper explores the effect of ultrasound-guided erector spinae plane block on the analgesic dose and incidence of adverse events during laparoscopic nephrectomy.Methods: A total of 60 patients underwent elective laparoscopic nephrectomy were randomly divided into erector spinae plane block(group E)and control group(group P),30 cases in each group.Routine general anesthesia was induced in both groups.In group E,0.5% ropivacaine 20 ml vertebral muscle plane block was placed on the surface of T10 transversely under ultrasound induction after the placement of the position.P group was not blocked.Both groups were given PCIA after surgery.Record the patient into the operating room(T0),anesthesia induction(T1),surgery start(T2),15 min during surgery(T3),30 min during surgery(T4),1h during surgery(T5),end of surgery(T6),out of the room(T7).Mean arterial pressure(MAP)and heart rate(HR)at each time point.The intraoperative time,intraoperative blood loss,total amount of sufentanil,and extubation time were recorded.The incidence of postoperative agitation,nausea,vomiting and other adverse reactions was recorded.VAS scores for maximum pain,postoperative PCIA pump compressions,and remedial analgesia were recorded at 0-24 h and 24-48 h postoperatively.Results: The intraoperative hemodynamic parameters of patients in group E were more stable.Compared with group P,the dose of sufentanil and the time of extubation were shorter in group E(p<0.05).There was no significant difference in the operation time and intraoperative blood loss(p>0.05).The incidence of adverse reactions in group E was lower than that in group P(p<0.05).The VAS scores for maximum pain in group E were lower than those in group P at 0-24 and 24-48h(p<0.05);the number of PCIA pump presses and the number of remedial analgesia in group E were lower than those in group P(p<0.05).Conclusion: Ultrasound-guided erector spinae plane block provides adequate analgesia during laparoscopic nephrectomy,which is conducive to hemodynamic stability,reduces perioperative analgesic use,and reduces the incidence of adverse reactions.