Effects of erector spinae plane block and retrolaminar block on analgesia for multiple rib fractures: a randomized, double-blinded clinical trial
Efeitos do bloqueio do plano eretor da espinha e do bloqueio retrolaminar na analgesia para fraturas de costelas múltiplas: um ensaio clínico duplo-cego randomizado
Yaoping Zhao; Yan Tao; Shaoqiang Zheng; Nan Cai; Long Cheng; Hao Xie; Geng Wang
Abstract
Keywords
Resumo
Objetivo: Investigar os efeitos do Bloco Plano Eretor da Espinha (ESPB) e do Bloco Retrolaminar (RLB) na analgesia intra e pós-operatória em pacientes com Fraturas Múltiplas de Costelas (MRFs).
Métodos: 80 pacientes com MRFs foram divididos aleatoriamente nos grupos ESPB (Grupo E) e RLB (Grupo R). Após anestesia geral, ESPB e RLB foram realizados sob orientação de ultrassom, respectivamente, juntamente com 20 mL de ropivacaína a 0,5% e analgesia intravenosa controlada pelo paciente (PCIA).
Resultados: Trinta e quatro casos no Grupo E e 33, casos no Grupo R apresentaram espaços paravertebrais obscuros. A dosagem intraoperatoria de remifentanil (média ± DP) (392,8 ± 118,7 vs. 501,7 ± 190,0 μg) e a dosagem de morfina PCIA pós-operatória, (7,35 ± 1,55 vs. 14,73 ± 2,18 mg) no Grupo R foram significativamente menores do que aquelas no Grupo E ; as pontuações da Escala Visual Analógica (VAS) no Grupo R em 2 (2,7 ± 1,2 vs. 3,4 ± 1,4), 4 (2,2 ± 1,1 vs. 2,8 ± 0,9), 12 (2,5 ± 0,9 vs. 3,0 ± 0,8) e 24 horas (2,6 ± 1,0 vs. 3,1 ± 0,9) após a cirurgia foram significativamente menores do que aquelas no Grupo E.
Finalmente, a atividade respiratória normal do diafragma (2,17 ± 0,22 vs. 2,05 ± 0,19), pH (mediana [IQR] (7,38 [7,31-7,45] vs. 7,36 [7,30-7,42]) e pressão parcial de carbono dióxido (PaCO2) (44 [35-49] vs. 42,5 [30-46]) após a operação no Grupo R foram significativamente melhores do que no Grupo E (p <0,05).
Conclusões: RLB foi um método analgésico mais eficaz do que ESPB no tratamento de MRF.
Palavras-chave
References
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Submitted date:
09/09/2019
Accepted date:
04/02/2021
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