广东医学2025，Vol.46Issue(1)：54-58,5.DOI:10.13820/j.cnki.gdyx.20241767
脂质体布比卡因竖脊肌阻滞用于腰椎融合术的镇痛效果
Erector spinae block with liposomal bupivacaine for analgesia in lumbar fusion surgery
摘要
Abstract
Objective To compare the efficacy of liposomal bupivacaine(LB)and levobupivacaine in erector spinae plane block(ESPB)for lumbar fusion surgery and evaluate the safety and effectiveness of LB in early postoperative analgesia,providing evidence for clinical low-opioid analgesia strategies.Methods Sixty patients scheduled for elec-tive lumbar fusion surgery were randomized into two groups:the liposomal bupivacaine group(LB group,n=30)and the levobupivacaine group(B group,n=30).Both groups received ESPB after general anesthesia.The LB group received 20 mL liposomal bupivacaine(266 mg)+40 mL normal saline,while the B group received 20 mL levobupivacaine(150 mg)+40 mL normal saline,with 20 mL injected per side.Pain numeric rating scale(NRS)scores were recorded at PACU(post-anesthesia care unit),and at 6,24,48,and 72 hours postoperatively.Perioperative sufentanil consump-tion,rescue analgesia,patient-controlled analgesia(PC A)pump usage,and postoperative adverse events were also re-corded.Results The LB group exhibited significantly lower movement NRS scores at PACU,24,48,and 72 hours post-operatively[1(1,2)、3(3,4)、3(2,3)、2(2,3)]compared to the B group[2(1,3)、4(4,4)、3(2.75,3)、3(2,3)](P＜0.05).Resting NRS scores were not significantly different between the groups(P＞0.05).The LB group consumed less sufentanil intraoperatively and at 24 and 48 hours postoperatively[(27.33±3.88)μg,(76.2±10.98)µg,(112.38±18.46)μg]than the B group[(31.50±4.76)µg,(83.52±9.36)µg,(121.98±15.91)µg,P＜0.05].PCA pump parameters,including total presses,effective presses,and analgesic drug consumption at 24 and 48 hours,were significantly lower in the LB group compared to the B group(P＜0.05).There were no significant differences in PACU stay time,hospitalization duration,or adverse events between the two groups(P＞0.05).Conclusion Liposo-mal bupivacaine can be safely used in lumbar fusion surgery,providing effective analgesia for up to 72 hours postoperative-ly while reducing perioperative opioid consumption,thus promoting early recovery.关键词
脂质体布比卡因/竖脊肌阻滞/腰椎融合术/镇痛Key words
liposomal bupivacaine/erector spinae block/lumbar fusion surgery/analgesia分类
医药卫生引用本文复制引用
王长红,周森,朱梦蝶,蒋毅..脂质体布比卡因竖脊肌阻滞用于腰椎融合术的镇痛效果[J].广东医学,2025,46(1):54-58,5.基金项目
中国红十字基金会医学赋能专项公益基金2023年镇痛行动临床科研项目(CRCF-YXFN-202302008) （CRCF-YXFN-202302008）
