The Relationship Between NLR and PONV and ESPB
- Conditions
- Erector Spinae Plane BlockNeutrophil to Lymphocyte Ratio
- Interventions
- Procedure: Erector Spinae Plane BlockProcedure: 0.9% physiological saline (20ml) injection under ultrasound-guided Erector Spinae Plane Block (ESPB).
- Registration Number
- NCT06127966
- Lead Sponsor
- Qianfoshan Hospital
- Brief Summary
This study aims to investigate whether preoperative NLR (Neutrophil-to-Lymphocyte Ratio) serves as a biomarker for PONV (Postoperative Nausea and Vomiting). It also examines the impact of erector spinae plane block on NLR and PONV. Furthermore, the research explores the effect of erector spinae plane block on postoperative pain relief in spinal surgery and its influence on the usage of opioid medications.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- NOT_YET_RECRUITING
- Sex
- All
- Target Recruitment
- 220
- Patients undergoing elective posterior lumbar spine surgery in a prone position under general anesthesia.
- ASA classification grades I to II.
- Age between 18 and 80 years old.
- Signed the informed consent for this study.
- Preoperative blood transfusion.
- Uncontrolled systemic diseases.
- Gastrointestinal system disorders.
- History of antiemetic and anticholinergic drug use.
- Adverse reactions related to surgery.
- Severe spinal deformities.
- Infection at the puncture site.
- Coagulation disorders.
- Long-term use of sedatives and analgesic drugs before surgery.
- Patients with mental illness or communication barriers.
- Allergic to ropivacaine.
- Participants involved in other clinical studies within the past 3 months.
- History of previous lumbar surgeries.
- Subjective unwillingness to participate in this study.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Erector Spinae Plane Block group(EA group + EB group) Erector Spinae Plane Block Conventional anesthesia induction, followed by ultrasound-guided erector spinae plane (ESPB) block with 0.5% ropivacaine (20 ml) after anesthesia induction. Control group（CA group + CB group) 0.9% physiological saline (20ml) injection under ultrasound-guided Erector Spinae Plane Block (ESPB). Conventional anesthesia induction, followed by ultrasound-guided injection of 0.9% saline (20 ml) into the erector spinae plane (ESPB) after anesthesia induction.
- Primary Outcome Measures
Name Time Method Record the need for antiemetic medication within the PACU and during the first 24 hours and the second 24 hours postoperatively. Within the first 24 hours and the second 24 hours after surgery. Record the need for antiemetic medication within the PACU and during the first 24 hours and the second 24 hours postoperatively.
Record the neutrophil count and lymphocyte count on the first day after surgery and calculate the neutrophil-to-lymphocyte ratio (NLR) Within the first 24 hours. The neutrophil count and lymphocyte count and calculate the neutrophil-to-lymphocyte ratio (NLR).
Record nausea and vomiting within the PACU and during the first 24 hours and second 24 hours after surgery. Within the first 24 hours and the second 24 hours after surgery. Patients with a nausea and vomiting score of 1 point or above (0 points = no nausea, 1 point = nausea, 2 points = dry heaving, 3 points = vomiting) are treated with ondansetron as an antiemetic.
- Secondary Outcome Measures
Name Time Method Document the occurrence rate of opioid-related side effects such as dizziness and urinary retention. Within 1 week Document the occurrence rate of opioid-related side effects such as dizziness and urinary retention.
Overall VAS (Visual Analog Scale) pain scores at 2 hours, 6 hours, 12 hours, 24 hours, and 48 hours postoperatively during rest and movement. At 2 hours, 6 hours, 12 hours, 24 hours, and 48 hours after surgery VAS scoring criteria, also known as pain level scoring criteria, use a visual analog method to assess the severity of pain.The VAS (Visual Analog Scale) rating ranges from 0 to 10, with a VAS score of 0 indicating no pain. Scores of 1-3 represent mild pain (pain does not affect sleep), 4-6 indicate moderate pain (pain disrupts sleep), 7-9 correspond to severe pain (unable to fall asleep or waking up due to pain, or unable to sleep), and a score of 10 signifies excruciating pain. The higher the score, the more severe the pain.
Record the satisfaction scores for pain management at 24 and 48 hours. Within the first 24 hours and the second 24 hours after surgery Patient satisfaction score refers to the postoperative satisfaction level of the patient, with 0 points indicating dissatisfaction, 1 point indicating fair, 2 points indicating satisfaction, and 3 points indicating very satisfied. The higher the score, the more satisfied the patient is with the treatment outcome.
Postoperative stay in the PACU (Post-Anesthesia Care Unit). Within 24 hours. Postoperative stay in the PACU (Post-Anesthesia Care Unit).
Record the postoperative awakening time. Within 24 hours. Record the postoperative awakening time.
Record the time of the initial press of the patient-controlled analgesia pump. Within the first 24 hours and the second 24 hours after surgery Record the time of the initial press of the patient-controlled analgesia pump.
Time of discharge post-surgery. Within 2 weeks. Time of discharge post-surgery.
Measure neutrophil extracellular trap (NETs) formation in serum on the first postoperative day. At 24 hours after surgery Measure neutrophil extracellular trap (NETs) formation in serum on the first postoperative day.
Record the time of the patient's initial self-administration of the pain pump during the first 24 hours and the second 24 hours after surgery. Within the first 24 hours and the second 24 hours after surgery Record the time of the patient's initial self-administration of the pain pump during the first 24 hours and the second 24 hours after surgery.
Record the extubation time after surgery. Within 24 hours. Record the extubation time after surgery.