头皮神经阻断在微血管减压后术后疼痛管理中的有效性:一项随机临床试验
Eun Kyung Lee1, Seungwon Lee2, Ji-Hye Kwon2
1Department of Anesthesiology and Pain Medicine, Chung-Ang University College of Medicine, Seoul 06973, Republic of Korea.
Journal of clinical medicine
|July 14, 2023
概括
在手术前进行头皮神经阻塞可能会减少在经历微血管减压的半面患者的早期术后疼痛. 然而,它并没有显著降低整体止痛药的使用,这表明需要进行更大规模的研究.
科学领域:
- 神经外科 神经外科
- 麻醉学 麻醉学
- 疼痛管理 疼痛管理
背景情况:
- 半面 (Hemifacial spasm,简称HFS) 是一种神经肌肉疾病,通常用微血管解压 (MVD) 治疗.
- 在MVD手术后,术后疼痛管理至关重要.
- 头皮神经阻塞用于控制手术疼痛,但它们在HFS MVD中的有效性尚未得到充分证实.
研究的目的:
- 评估手术前头皮神经阻塞在接受HFS的MVD患者的疗效.
- 评估头皮神经阻塞对术后疼痛,止痛药消耗和恢复的影响.
主要方法:
- 一项前性研究涉及74名接受HFSMVD的患者.
- 患者被分为一个阻断组 (接受头皮神经阻断和0.5%的罗皮瓦卡因) 和一个控制组.
- 主要结局:术后24小时的累积救援止痛剂量. 二级结局:疼痛评分,抗药消耗,以及康复质量-15级.
主要成果:
- 在24小时的累积救援止痛剂剂量中,两组之间没有显著差异 (p=0.633).
- 经过手术后6,12和24小时,阻断组的疼痛得分显著降低.
- 在12小时后的阻断组中降低了术后抗药的消耗.
结论:
- 手术前的头皮神经阻塞可能会减少HFS的MVD后的早期术后疼痛.
- 阻断剂并没有显著降低整体止痛药的需求.
- 需要采用多式联络方法进行更大规模的研究,以确认头皮神经阻塞在这种患者群体中的有效性.
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