长效布皮瓦卡因用于剖腹产产后的疼痛控制
Nursing for women's health
|June 29, 2023
概括
剖腹产的新麻醉技术显著减少了手术后的疼痛和阿片类药物的使用. 与标准护理相比,脂质体布皮瓦卡因伤口透 (LB INF) 和横腹平面 (TAP) 阻断 (LB TAP) 降低了阿片类药物消耗和疼痛评分.
科学领域:
- 麻醉学 麻醉学
- 产科 产科 产科 产科 产科
- 疼痛管理 疼痛管理
背景情况:
- 剖腹产是一个常见的外科手术程序.
- 有效的疼痛管理对于产后恢复至关重要.
- 治疗剖腹产后疼痛的阿片类药物使用可能会导致依赖,特别是在阿片类药物使用障碍率高的地区.
研究的目的:
- 为了比较标准阿片类药物管理和增强局部麻醉技术之间的剖腹产后疼痛和阿片类药物消费.
- 评估脂质体布皮瓦卡因伤口透 (LB INF) 和横向腹部平面 (TAP) 阻塞 (LB TAP) 与常规脊柱麻醉的疗效.
主要方法:
- 对402名经历剖腹产的妇女进行了回顾性队列研究.
- 干预包括常规脊髓麻醉,LB INF和LB TAP.
- 收集了手术后吗啡毫克相当量 (MME),疼痛评分和阿片类药物使用史的数据.
主要成果:
- 与标准护理组相比,LB INF和LB TAP组每天的MME显著降低 (p < .001).
- 在术后0日和1日,LB INF显示疼痛得分较低;在术后1日,LB TAP显示疼痛得分较低 (p < .004).
- 患有药物使用障碍史的妇女报告疼痛更高,使用更多的阿片类药物,并且在医院住院时间更长,无论麻醉类型 (p < .001).
结论:
- 脂质体布皮瓦卡因伤口透和TAP阻断与剖腹产后减少阿片类药物使用有关.
- 与标准护理相比,这些增强局部麻醉技术有效地降低了术后疼痛得分.
- 针对性麻醉方法可以改善剖腹产患者的结果,包括那些有药物使用史的人.
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