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内静脉与周围神经德克萨米他用于减少跨骨阻塞后的反弹疼痛:一项随机对照试验
Hyun Jung Lee1, Jae Hee Woo2, Ji Seon Chae1
1Department of Anesthesiology and Pain Medicine, College of Medicine, Ewha Womans University Seoul Hospital, Seoul, Korea.
Journal of Korean medical science
|June 20, 2023
概括
静脉注射德克萨米他有效地减少了反弹疼痛,并在旋转袖口修复中进行间层臂阻塞 (ISB) 后改善了睡眠,与周围神经管理相比. 这表明IV德克萨米他对治疗ISB后的术后疼痛更有好处.
科学领域:
- 麻醉学 麻醉学
- 整形外科手术 整形外科手术
- 药理学 药理学是指药理学的学科.
背景情况:
- 间层臂阻塞 (ISB) 是一种用于关节镜旋转手套修复的标准区域麻醉技术.
- 在ISB之后的反弹疼痛可以减少区域麻醉的好处.
- 调查周围神经与静脉注射德甲在缓解反弹疼痛方面的比较疗效至关重要.
研究的目的:
- 为了比较周围神经和静脉注射德甲对ISB解决后的反弹疼痛的影响.
- 评估德克萨米他给药途径对术后疼痛和恢复的影响.
主要方法:
- 随机对照试验涉及患者进行关节镜旋转手套修复与手术前ISB.
- 参与者接受了周围神经或静脉注射的甲.
- 评估了疼痛评分,反弹疼痛发生率,持续时间,强度,第一次止痛要求的时间和睡眠障碍.
主要成果:
- 静脉注射德甲组在ISB解决后的疼痛增加显著减少,与周围神经组 (4.0对4.9) 相比.
- 在静脉注射组中,反弹疼痛 (20.0%vs.44.4%) 和与疼痛相关的睡眠障碍 (25.7%vs.55.6%) 的发生率明显较低.
- 周围神经甲松提供了更长的ISB止痛时间 (19.9小时 vs 15.1小时).
结论:
- 静脉注射德克萨米他在减少ISB解决后疼痛增加和最大限度地减少反弹疼痛方面比围神经德克萨米他更有效.
- 静脉注射德克萨米他也导致了手术后与疼痛相关的睡眠障碍的发病率较低.
- 虽然围性德克萨米他延长了阻断时间,但静脉注射提供了对反弹疼痛和相关并发症的优越管理.
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