Optimization strategies of anesthesia for pediatric patients with pectus excavatum undergoing Nuss procedure: ultrasound-guided erector spinae plane block combined with general anesthesia
10.3760/cma.j.cn131073.20240104.00814
- VernacularTitle:漏斗胸患儿Nuss术麻醉的优化策略：超声引导竖脊肌平面阻滞联合全身麻醉
- Author:
Yi REN
1
;
Lei HUA
;
Fuzhou ZHANG
;
Yangwei MA
;
Tiehua ZHENG
;
Zenghua XU
;
Jianmin ZHANG
Author Information
1. 国家儿童医学中心 首都医科大学附属北京儿童医院麻醉科，北京 100045
- Keywords:
Erector spinae;
Nerve block;
Anesthesia, general;
Funnel chest;
Child;
Hyperalgesia
- From:
Chinese Journal of Anesthesiology
2024;44(8):972-976
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the optimization effect of ultrasound-guided erector spinae plane block (ESPB)combined with general anesthesia on Nuss procedure in pediatric patients with pectus excavatum undergoing Nuss procedure.Methods:One hundred and eight pediatric patients of either sex, aged 7-18 yr, with body mass index within the normal range, of American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, undergoing elective Nuss procedure, were randomized into 3 groups ( n=36 each) using a random number table method: ultrasound-guided ESPB combined with general anesthesia group (group E), thoracic epidural anesthesia plus general analgesia group (group T), and general analgesia group (group G). Pediatric patients received ultrasound-guided bilateral ESPB (0.3% ropivacaine was injected, 0.5 ml/kg bilateral total volume [maximum 20 ml]) or thoracic epidural anesthesia (0.3% ropivacaine 0.5 ml/kg [maximum 20 ml/side]) after induction of anesthesia in group E and group T, respectively. All the three groups underwent general anesthesia, anesthesia was induced with propofol 2-3 mg/kg, sufentanil 0.3-0.5 μg/kg and cis-atracurium 0.1-0.2 mg/kg and maintained with propofol 6-10 mg·kg -1·h -1 and remifentanil 0.1-0.3 μg·kg -1·min -1. The patients were endotracheally intubated and mechanically ventilated after anesthesia induction. The parent-controlled intravenous analgesia (PCIA) was used for patients in all the three groups postoperatively. The consumption of intraoperative remifentanil and postoperative consumption of sufentanil for PCIA in each period after surgery were recorded. The time to the first rescue analgesia, consumption of ibuprofen and postoperative complications were also recorded. Results:Compared with group G, the intraoperative consumption of remifentanil and postoperative consumption of sufentanil for PCIA in each period were significantly decreased, the time to the first rescue analgesia was prolonged, and the consumption of ibuprofen was decreased in group E ( P<0.05). There was no significant difference among the three groups ( P>0.05). Conclusions:ESPB combined with general analgesia is helpful in reducing postoperative hyperalgesia in pediatric patients undergoing the Nuss procedure.
