In recent years,the rapid development of fascia plane block technique has played a cru-cial role in the development of multi-modal analgesic strategies in spinal surgery.Compared with traditional intraspinal anesthesia,fascia plane block has the advantages of simple operation,safety,good analgesic effect,no interference to intraoperative nerve monitoring and early postoperative inspection.In this artical,we reviewed the clinical application advances of fascia plane blocks commonly used in spinal surgery,such as transversal abdominis plane block(TAPB),thoracolumbar interfascial plane block(TLIPB),erector spinae plane block(ESPB),mid-point transverse process to pleura block(MTPB),multifidus plane block(MPB),and inter semispinal plane block(ISPB),in order to provide reference for multi-mode analgesia in spinal surgery.

Objective To observe the effect of ultrasound-guided single erector spinae plane (ESP ) block combined with patient-controlled intravenous analgesia (PCIA ) on postoperative analgesia in patients undergoing lobectomy performed via video-assisted thoracoscope. Methods Forty patients (20 males and 20 females,ASA physical status Ⅰ or Ⅱ),scheduled for e-lective video-assisted thoracoscopic lobectomy,were randomly assigned into two groups,ESP block combined with PCIA group (group EP)and PCIA only group (group P).ESP block was given to pa-tients in group EP before operation,and its effect was evaluated by testing the area of block.VAS scores were recorded at 1,6,18,24 and 48 h after operation.The frequency for compress PCIA,the volume of analgesic drugs,the consumption of flurbiprofen axetil and the side-effects were recorded as well.Results ESP block was accomplished in group EP with sensory loss from T2-T8 or T3-T7 over the entire posterolateral aspect of the hemithorax.And there were no puncture-related complications. The VAS scores both at rest and coughing in group EP were lower than those in group P (P <0.05). The compress PCA numbers,the volume of analgesic drugs and the consumption of flurbiprofen axetil were significantly less in group EP than those in group P (P <0.05).Only nausea and vomiting were observed as postoperative side effects,and there were no significant differences between the two groups.Conclusion Ultrasound-guided single erector spinae plane block combined with PCIA is a sa-fer and more effective method for the analgesia of thoracic operation than PCIA only.

Objective To investigate the effect of transcutaneous electrical acupoint stimulation(TEAS)on emergence agitation(EA)in children undergoing selective posterior rhizotomy(SPR).Methods Forty-two children with cerebral palsy undergoing SPR were selected,20 males and 22 females,aged 6-12 years,BMI 13-24 kg/m2,ASA physical status Ⅰ or Ⅱ,randomly divided into two groups:TEAS group(group T)and control group(group C),21 children in each group.Children in group T re-ceived TEAS at the bilateral acupoints of Neiguan and Hegu from 30 minutes before anesthesia induction to the end of surgery.In group C,electrodes were placed on the same acupoints without electrical stimulation.All children in both groups received total intravenous anesthesia.HR and MAP were recorded at the time of entry,extubation,5,15,30 minutes after extubation.The consumption of remifentanil and propofol during the procedure were recorded.The time of operation and extubation were recorded.The Wong-Baker faces pain scale-revised(FPS-R)and the pediatric anesthesia emergence delirium(PAED)were recorded at 15 minutes after extubation,and the incidence of EA was assessed by PAED.While,the occurrence of post-operative nausea and vomiting(PONV)was recorded.Results Compared with that at the time of entry,HR at the time of extubation,5,15 minutes after extubation and MAP at the time of extubation,5,15,30 minutes after extubation in group C were significantly increased(P＜0.05),HR and MAP at the time of extubation,5,15 minutes after extubationin group T were significantly increased(P＜0.05).Compared with group C,HR was significantly slower and MAP was significantly lower in group T at the time of extuba-tion,5,15,30 minutes after extubation(P＜0.05).Compared with group C,the consumption of remifen-tanil during operation was reduced,the time of extubation was significantly shortened,the FPS-R and PAED were significantly decreased,and the incidence of EA were significantly reduced(P＜0.05).There were no significant differences in the time of operation,the consumption of propofol during operation and the inci-dence of PONV.Conclusion TEAS is beneficial to prevent the occurrence of EA in pediatric patients un-dergoing SPR,stabilize hemodynamics,reduce the dosage of opioids during surgery,reduce the postopera-tive pain,andaccelerate the time of anesthesia resuscitation.