多模式止痛与局部伤口透和静脉注射帕雷可西布用于甲状腺切除术
Tz-Ping Gau1,2,3, Sheng-Hua Wu4,5, Jui-Mei Huang2
1Department of Anesthesiology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
Medicina (Kaunas, Lithuania)
|May 27, 2023
概括
增强的利多卡因伤口透与静脉注射帕雷科克西布相结合,有效地减少了甲状腺切除术后的术后疼痛. 这种多模式止痛方法在运动和咳期间改善了疼痛控制,副作用最小.
科学领域:
- 麻醉学 麻醉学
- 手术疼痛管理手术疼痛管理
背景情况:
- 有效的术后疼痛控制对于患者在甲状腺切除术后恢复至关重要.
- 多模式止痛策略通常用于治疗手术疼痛.
- 利多卡因的伤口透和表面椎结交阻塞是甲状腺手术中公认的疼痛管理技术.
研究的目的:
- 在接受甲状腺切除术的患者中,评估使用利多卡因伤口透与静脉注射帕雷科克西布结合的多模式止痛疗法的疗效.
- 为了比较不同剂量的利多卡因透剂之间的疼痛强度和不良事件.
主要方法:
- 对101名接受甲状腺切除术的患者进行了回顾性分析,并采用了多模式止痛方案.
- 患者接受了5毫升 (I组,对照) 或10毫升 (II组,研究) 1%的利多卡因与上腺素透,以及40毫克静脉注射帕雷科克西布.
- 疼痛强度在术后麻醉护理单位和术后第一天使用数值评分表 (NRS) 进行评估.
- 二次结局包括麻醉相关的副作用和肺部并发症.
主要成果:
- 与I组相比,II组 (10毫升利多卡因) 的患者在术后麻醉护理单位报告运动时疼痛强度显著降低 (NRS 1.47 ± 0.89对1.85 ± 0.96,p=0.043) 和咳 (NRS 1.61 ± 0.95对1.96 ± 0.79,p=0.049) 在术后麻醉护理单位 (5毫升利多卡因).
- 大多数患者没有或轻度经历手术后疼痛.
- 没有报告严重的不良事件;I组的一名患者经历了暂时的声乐.
结论:
- 多种模式的止痛与利多卡因伤口透和静脉注射帕雷科克西布提供有效的止痛后甲状腺切除术.
- 较高的利多卡因透体积 (10毫升) 与较低的体积 (5毫升) 相比,可以在运动和咳时提供更好的疼痛控制.
- 这种镇痛方法与最小的不良事件有关,包括暂时的声音.
相关概念视频
Analgesia and Pain Management
673
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
673
Local Anesthetics: Clinical Application as Epidural Anesthesia
461
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
461
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
489
Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
One of the advantages of...
489
Local Anesthetics: Clinical Application as Spinal Anesthesia
690
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
690
Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia
1.1K
Depending on the target organ, local anesthetics (LAs) can be administered via various routes. In surface anesthesia, LAs are applied directly to the surface of the skin or mucous membranes. It is widely used for topical skin numbing before venipuncture or minor surgical procedures. Commonly used surface local anesthetics are lidocaine or benzocaine sprays or creams. Surface anesthesia occurs within 5 minutes and lasts for about 60 minutes. One of the main disadvantages of topical anesthesia is...
1.1K
Inflammatory Bowel Disease V: Surgical Management
174
Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
Here are some common surgical interventions for IBD:
174


