胸部脊髄麻酔と勃起器脊髄平面ブロック 対 意識的鎮静 医療胸腔鏡検査:比較パイロット研究
Archana Baburao1, Parinita Suresh2, Sudeeksha P2
1Respiratory Medicine, Rajarajeswari Medical College and Hospital, Dr. M.G.R. Educational and Research Institute, Bangalore, IND.
Cureus
|February 16, 2026
まとめ
勃起器脊柱平面ブロックと組み合わせた胸椎脊髄麻酔は,意識的な鎮静と比較して,医療胸腔鏡患者の優れた疼痛緩和とより迅速な回復を提供します. この麻酔テクニックは,患者の治療結果を改善し,処置時間を短縮します.
科学分野:
- アネステシオロジー アネステシオロジー
- 胸部外科手術について
- 疼痛管理 疼痛管理
背景:
- 医療用胸腔鏡検査 (MT) は,多くの場合,手術後の大きな痛みと罹病率をもたらします.
- 効果的な疼痛管理は,MT後の患者の回復を改善するために不可欠です.
研究 の 目的:
- 胸脊髄麻酔 (TSA) と勃起器脊髄平面ブロック (ESPB) の併用による胸脊髄麻酔 (TSA) の有効性をMTの意識的鎮静と比較するために.
- 回復の質と術後の鎮痛を含む患者中心のアウトカムを評価する.
主な方法:
- ランダム化されていない前向き比較試験試験で,MTを受けた36人の患者が参加した.
- 患者は,TSAとESPBまたは意識的鎮静 (フェンタニル,ミダゾラム,局所リグノカイン) のいずれかを交互に割り当てられました.
- 主なアウトカムは回復の質 (QoR-15スコア) であり,次要のアウトカムには,最初の鎮痛薬までの時間,24時間のオピオイド摂取量,および処置期間が含まれていました.
主要な成果:
- ESPBグループによるTSAは,回復の品質-15のスコア (112.83 ± 27.16 vs. 65.78 ± 22.13, p=0.0001) が著しく高いことを示した.
- 最初の鎮痛薬までの時間は,ESPBグループではより長かった (11.69 ± 6.93 時間対 2.39 ± 1.69 時間,p = 0.0001).
- オピオイドの摂取量はESPBグループでは低かった (50 ± 10 vs. 75 ± 15, p=0.001),処置期間は短かった (64.72 vs. 93.89分, p=0.0001).
結論:
- エレクター脊柱平面ブロックと組み合わせた胸脊髄麻酔は,医療用胸腔鏡検査のための安全で効果的な麻酔技術です.
- この組み合わせは,回復の質を向上させ,術後の鎮痛を促進し,処置期間を短縮し,外科手術後の罹病率を減少させます.
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