在局部麻醉式胸腔镜中多层次肋间神经块的作用
Syed Ajmal1, Sarah Johnstone, Muhammad Tufail
1Department of Respiratory, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester.
Journal of bronchology & interventional pulmonology
|July 13, 2023
概括
多层肋间神经阻塞 (ICNB) 显著减少了手术后的疼痛和住院时间 (LOS) 在接受局部麻醉胸腔镜 (LAT) 的患者. 这种先进的止痛技术改善了患者的治疗结果和康复.
科学领域:
- 胸部外科手术 胸部外科手术
- 疼痛管理 疼痛管理
- 麻醉学 麻醉学
背景情况:
- 局部麻醉胸腔镜 (LAT) 仅在端口插入部位提供麻醉.
- 在LAT期间进行活检的壁膜,仍然没有麻醉,导致潜在的患者疼痛.
- 肋间神经阻断 (ICNB) 是一种已知的胸部止痛技术.
研究的目的:
- 为了比较LAT与多层次肋间神经阻断 (ICNB) 与标准护理的疗效.
- 评估ICNB对手术后疼痛,止痛使用,住院时间 (LOS) 和并发症的影响.
主要方法:
- 对接受LAT的患者进行了前性分析.
- 肋间神经阻断 (ICNB) 组在LAT之前接受了Levobupivacaine/xylocaine,在最大5个肋间间隔处方.
- 疼痛被评估使用视觉模拟得分 (VAS) 在1和2小时后的程序和每天,以及监测止痛药的使用.
主要成果:
- 与标准护理相比,ICNB组显示VAS疼痛得分显著降低:在1-2小时后55毫米,LAT后1天45毫米 (P <0.05).
- 在ICNB组中,住院时间 (LOS) 的中位数减少了50% (P <0.05).
- 在ICNB组中,止痛药的使用,特别是,减少了56% (P <0.05).
结论:
- 多层间肋间神经阻断 (ICNB) 是一种有效的方法,可在局部麻醉胸腔镜 (LAT) 后显著减少术后疼痛.
- 此外,ICNB还有助于减少住院时间 (LOS),这表明患者的康复和资源利用得到改善.
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