在机器人神经腹术过程中具有不同气息压力的疼痛:随机对照试验
Gabriella M Rustia1, Michael G Baracy, Emilee Khair
1Department of Obstetrics and Gynecology, the Department of Biomedical Investigations and Research, and the Division of FPMRS, Department of Obstetrics and Gynecology, Ascension St. John Hospital, Detroit, and Michigan State University, East Lansing, Michigan.
Obstetrics and gynecology
|June 22, 2023
概括
在机器人辅助神经腹术期间降低呼吸压力,显著降低了术后疼痛和阿片类药物消耗. 这一发现为接受这种常见的妇科手术的患者提供了更安全的方法.
科学领域:
- 泌尿和妇科 泌尿和妇科
- 最少侵入性的手术
- 外科手术的结果
背景情况:
- 机器人辅助神经骨切除术是一种常见的骨盆器官脱落的手术.
- 机器人手术期间腹内压力升高可能会导致术后疼痛.
- 优化灌气压力对于患者的舒适和康复至关重要.
研究的目的:
- 为了确定降低吸气压是否会降低手术后疼痛和阿片类药物需求,在接受机器人辅助圣术的妇女中.
- 为了比较疼痛评分和阿片类药物使用在较低 (12 mm Hg) 和标准 (15 mm Hg) 吸气压组之间.
主要方法:
- 一个单盲随机试验,涉及患有骨盆器官脱落的妇女.
- 参与者被分配到机器人辅助的阴道切术中,输气压为12 mm Hg或15 mm Hg.
- 主要结局:术后1天的疼痛视觉模拟量表 (VAS);次要结局:门诊疼痛,阿片类药物使用,手术时间,失血.
主要成果:
- 下呼吸压组 (12 mm Hg) 在术后第一天报告疼痛明显减少 (VAS 中位数为17.0 mm与29.0 mm,P=.007).
- 较低血压组在住院和门诊康复期间使用的阿片类药物较少 (分别P=0.04和P=.02).
- 在手术时间,估计的血液损失或停留时间方面没有发现显著差异.
结论:
- 在机器人辅助神经腹术期间将呼吸压降至12mm Hg,是减少术后疼痛的安全有效方法.
- 这种方法也导致阿片类药物消费减少,改善患者的康复.
- 这些发现支持在此过程中使用降低吸气压作为标准护理.
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