大量患者控制的外围注射与用于分娩止痛的编程间歇性外围注射:一项随机对照研究
E Roofthooft1,2, N Filetici3, M Van Houwe3
1Department of Anaesthesiology, GZA Sint Augustinus Hospital, Antwerp, Belgium.
Anaesthesia
|June 21, 2023
概括
患者控制的外周止痛疗法 (PCEA) 提供了与用于分娩止痛的编程间歇性外周止痛疗法 (PIEB) 相比的缓解疼痛. PCEA在管理突破性疼痛和局部麻醉剂消费的卓越效率方面表现出非劣势.
科学领域:
- 产科和妇科 产科和妇科
- 麻醉学 麻醉学
- 疼痛管理 疼痛管理
背景情况:
- 神经轴性止痛疗法旨在有效缓解疼痛,并减少副作用.
- 编程间歇性外围注射 (PIEB) 是一种新的外围止痛维护技术.
- 之前的研究在比较PIEB和患者控制的外周止痛疗法 (PCEA) 之间的玻尿酸体积方面存在局限性.
研究的目的:
- 为了比较PCEA与PIEB用于分娩止痛的疗效和安全性,使用相同的玻尿酸体积.
- 为了确定PCEA在突破性疼痛方面的非劣势性.
- 评估PCEA在局部麻醉剂消费中的优越性.
主要方法:
- 一个随机的,多中心的,非劣等性试验,涉及360名女性.
- 参与者被分配到单纯PCEA或PIEB组,两者都使用10毫升螺栓.
- 主要结局包括突破性疼痛发生率和总止痛剂摄入量;次要结局包括运动阻断,疼痛评分,满意度和孕产妇/新生儿结局.
主要成果:
- 突破性疼痛在两组之间是相似的 (11.2%的PCEA与10.8%的PIEB),符合非劣等标准.
- 在PCEA组中,罗皮瓦卡因的总消费量明显较低 (平均差异为15.3毫克,p < 0.001).
- 运动阻断,患者满意度和母亲/新生儿结局在两组中都是相似的.
结论:
- 患者控制的外周止痛疗法 (PCEA) 在给予相同量的产痛时,与用于产痛的编程间歇性外周止痛疗法 (PIEB) 不逊色.
- 与PIEB相比,PCEA在减少局部麻醉剂消耗方面表现出优越性.
- 这两种技术都为分娩妇女提供了可比的疼痛缓解和安全概况.
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