在重复的外围神经阻塞下进行大型脚和后脚手术后缓解疼痛:可行性研究
Kjartan E Hannig1,2, Rasmus W Hauritz1, Siska Bjørn3
1Department of Anaesthesiology, Kolding Hospital, a part of Lillebaelt Hospital, University Hospital of Southern Denmark, Denmark.
Acta anaesthesiologica Scandinavica
|June 6, 2023
概括
在关节手术中,重复注射一次性神经阻塞可以在48小时内有效缓解疼痛. 这种方法显著减少了阿片类药物的使用,为连续导管阻塞提供了更好的替代方案.
科学领域:
- 麻醉学 麻醉学
- 整形外科手术 整形外科手术
- 疼痛管理 疼痛管理
背景情况:
- 主要的脚和后脚手术往往会导致严重的术后疼痛,特别是在前48小时.
- 使用导管的连续外围神经阻塞是常见的,但由于导管位移,其有效性降低.
- 需要使用替代方法来确保长期有效的术后止痛.
研究的目的:
- 评估一次重复注射的外周神经阻塞在术后疼痛管理中的有效性.
- 为了评估在接受重大脚和后脚手术的患者中阿片类药物的消耗.
主要方法:
- 11名患者接受了长效局部麻醉剂混合剂的单次注射波立体坐骨神经和软骨神经阻塞.
- 在初始阻塞后大约24小时,一次重复注射神经阻塞.
- 疼痛评分和累积阿片类药物消费记录在前48个术后小时.
主要成果:
- 82%的患者 (共9例,11例) 在前48小时内经历了没有阿片类药物的有效止痛.
- 仅有两名患者在43小时后需要单剂口服吗啡等效剂 (7.5毫克).
- 重复的神经阻塞技术在疼痛控制方面表现出高效.
结论:
- 单次注射的坐骨神经和神经阻塞一次性重复提供了连续和有效的止痛治疗48小时后主要的脚和后脚手术.
- 这种方法提供了疼痛缓解与最小的阿片类药物需求.
- 重复的神经阻塞是连续导管输注的可行的替代方案,用于术后疼痛管理.
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