Superior effects of thoracic epidural block for analgesia in patients with severe acute pancreatitis
10.3760/cma.j.cn131073.20210120.00519
- VernacularTitle:胸段硬膜外阻滞用于重症急性胰腺炎患者镇痛时的优势效应
- Author:
Wu CHEN
1
;
Bao FU
;
Fei GAO
;
Jie HU
;
Dahua DAI
;
Tian YU
;
Enqiang MAO
;
Xiaoyun FU
Author Information
1. 遵义医科大学附属医院重症医学一科 563000
- Keywords:
Analgesia, epidural;
Pancreatitis, acute necrotizing;
Treatment outcome
- From:
Chinese Journal of Anesthesiology
2021;41(5):589-592
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the superior effect of thoracic epidural block (TEB) used for analgesia in patients with severe acute pancreatitis (SAP).Methods:Fifty patients of both sexes, aged 18-64 yr, with SAP, with Japanese severity score (JSS) ≥3, onset time of SAP≤12 h, were divided into conventional analgesia group (group C) and TEB group.Sufentanil was intravenously infused for analgesia in group C. TEB was performed for analgesia in group TEB.In group C, sufentanil was intravenously infused at a rate of 0.2-0.3 μg·kg -1·h -1 after admission to hospital.In group TEB, an epidural catheter was placed at T 9, 10 interspace, and 0.66% lidocaine mixed with 0.33% ropivacaine was epidurally infused at a rate of 3-5 ml/h for 120 h after admission to hospital.Visual analog scale (VAS) score and intra-abdominal pressure (IAP) were recorded at 1, 24, 48, 72 and 120 h of analgesia.HR, respiratory rate (RR), oxygenation index, computed tomography severity index (CTSI), JSS and Ranson scores were recorded at 24, 72 and 120 h of analgesia, and the de-criticalization within 72 h following analgesia was evaluated. Results:Compared with group C, VAS score and IAP were significantly deceased at each time point ( P<0.05), the rate of de-criticalization (60%/90%) was increased ( P<0.05), and Ranson score, CTSI score and JSS score were decreased at 120 h of analgesia in group TEB ( P<0.05). Conclusion:TEB can not only produce good analgesic effect, but also improve the development of the disease, which has superior effect compared with routine analgesia when used for the treatment of SAP.
