深度神经肌肉阻断减轻慢性术后疼痛,增强脊柱手术后的长期术后恢复:一项随机对照试验
Xihui Tang1,2, Yan Wu1,2, Qingsong Chen1,2
1Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, 99 Huaihai West Road, Xuzhou, Jiangsu, 221000, People's Republic of China.
Pain and therapy
|June 6, 2023
概括
深度神经肌肉阻断 (DNMB) 显著减少脊髓手术后的慢性术后疼痛 (CPSP) 和阿片类药物使用. 这种技术还可以提高接受这些手术的患者的长期康复质量.
科学领域:
- 麻醉学 麻醉学
- 术后恢复 术后恢复
- 疼痛管理 疼痛管理
背景情况:
- 深度神经肌肉阻断 (DNMB) 对慢性术后疼痛 (CPSP) 和脊髓手术后长期恢复的影响尚不清楚.
- 关于DNMB对脊柱后手术恢复质量的影响的研究有限.
研究的目的:
- 调查DNMB对CPSP发生率的影响.
- 评估DNMB对脊柱手术后长期康复的质量的影响.
主要方法:
- 一项随机,受控,双盲研究,涉及220名脊柱手术患者.
- 患者接受了DNMB (后计数1-2) 或中度神经肌肉阻断 (MNMB) (四人列车1-3).
- 主要终点是CPSP发生率;次要终点包括疼痛评分 (VAS),阿片类药物消耗和恢复质量-15 (QoR-15) 评分.
主要成果:
- 与MNMB组 (42.86%) 相比,DNMB组的CPSP发病率明显较低 (28.85%) (p=0.035).与MNMB组相比,DNMB组的CPSP发病率明显较低 (28.85%).
- 在手术后3个月的DNMB组 (p=0.016) 和更早的时间点 (PACU,12小时) 观察到较低的VAS得分.
- 在DNMB组消耗的术后阿片类药物显著减少,并在3个月后报告了更高的QoR-15分数 (p=0.003).
结论:
- 在脊柱外科手术中,DNMB在减少CPSP和术后阿片类药物消耗方面比MNMB更有效.
- DNMB的使用改善了经过脊柱手术的患者的长期康复质量.
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