对于成年人来说,疼痛控制的演变 Pectus Excavatum修复
Dawn E Jaroszewski1, Peter Bostoros1, Juan M Farina1
1Department of Cardiovascular and Thoracic Surgery, Mayo Clinic, Phoenix, Arizona.
The Annals of thoracic surgery
|June 6, 2023
概括
肋间神经缩显著减少住院时间和阿片类药物的使用,用于微创性修复胸部挖掘 (MIRPE) 患者. 这种疼痛控制方法比外周治疗或SC-Cath技术具有优势,与阿片类药物相关的并发症相比较少.
科学领域:
- 胸部外科手术 胸部外科手术
- 疼痛管理 疼痛管理
- 最少侵入性手术是最少侵入性的手术.
背景情况:
- 在微创伤性修复胸部挖掘 (MIRPE) 后的疼痛管理具有挑战性,特别是在成年人中.
- 这项研究评估了MIRPE后十年使用的止痛策略.
研究的目的:
- 在成人患者中比较MIRPE后不同止痛方式的疗效和结果.
- 确定最佳的疼痛管理策略,以改善患者的康复.
主要方法:
- 对接受初级MIRPE的729名成年患者的回顾性分析 (2010年10月 - 2021年12月).
- 根据止痛方式分类的患者:外围注射,弹性体连续输液皮下导管 (SC-Caths) 和肋间神经冷.
- 组之间的阿片类药物需求,住院时间,并发症率和疼痛评分的比较.
主要成果:
- 化组显示了显著较低的吗啡等效剂量 (P < .001) 和最短的住院时间 (平均1.9天,P < .001).
- 在冷凍解凍組 (P < .001) 中,乳頭和便秘合併症較少 (P = .001),但肺流的發生率較高 (P = .024).
- 所有组的平均疼痛分数都很低 (<3),没有显著差异.
结论:
- 结合增强的恢复途径,结合 intercostal神经冷,为MIRPE患者提供了显著的好处.
- 减少住院时间,减少在医院内使用阿片类药物,以及较少的阿片类药物相关并发症.
- 需要进行进一步的研究来评估冷后解剖治疗的长期益处.
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