Optimization strategy of anesthesia for laparoscopic nephrectomy in elderly patients: ultrasound-guided erector spinae plane block combined with total intravenous anesthesia
10.3760/cma.j.cn131073.20240105.00611
- VernacularTitle:老年患者腹腔镜肾切除术麻醉的优化策略：超声引导竖脊肌平面阻滞联合全凭静脉麻醉
- Author:
Liheng DU
1
;
Yujing YUAN
;
Lei WAN
;
Chengwen LI
;
Fushan XUE
Author Information
1. 首都医科大学附属北京友谊医院麻醉手术中心，北京 100050
- Keywords:
Ultrasonography;
Nerve block;
Anesthesia, general;
Laparoscopy;
Nephrectomy;
Aged
- From:
Chinese Journal of Anesthesiology
2024;44(6):702-704
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the optimization strategy of anesthesia for laparoscopic nephrectomy in elderly patients using ultrasound-guided erector spinae plane block combined with total intravenous anesthesia.Methods:This was a prospective randomized controlled study. Seventy elderly patients, aged 60-80 yr, with a body mass index of 22-30 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅰ-Ⅲ, scheduled for elective/limited laparoscopic nephrectomy under total intravenous anesthesia in our hospital from April to October 2023, were divided into a total intravenous anesthesia group (TIVA group) and an ultrasound-guided erector spinae plane block combined with total intravenous anesthesia group (ESPB group) using a random number table method, with 35 cases in each group. Two groups used the same general anesthesia regimen. The ultrasound-guided erector spinae plane block was performed at the T 11 level after general anesthesia, and 0.3% ropivacaine 30 ml was injected after the successful puncture in ESPB group. The postoperative quality of recovery was assessed using the 15-item Quality-of-Recovery scale. The postoperative rescue analgesia and occurrence of adverse reactions were recorded. Results:Compared with TIVA group, the 15-item Quality-of-Recovery scale score was significantly increased, the rate of postoperative rescue analgesia was decreased, and the incidence of adverse reactions was decreased in ESPB group ( P<0.05). Conclusions:Ultrasound-guided erector spinae plane block combined with total intravenous anesthesia is beneficial for the postoperative outcomes of elderly patients undergoing laparoscopic nephrectomy.
