持续的外周止痛疗法与持续的外周神经阻塞在单边下肢儿科整形外科手术:一个匹配的案例比较研究
Neeraj Vij1, Neil R Singhal2, Daniel Trif3
1Orthopedic Surgery, University of Arizona College of Medicine - Phoenix, Phoenix, USA.
Cureus
|July 17, 2023
概括
持续的外周神经阻塞 (CPNBs) 提供类似的疼痛缓解持续的外周止痛 (CEA) 儿童下肢手术后. CPNB的结果是更快的行走和更少的副作用,这表明它们在儿科疼痛管理中的潜力.
科学领域:
- 麻醉学 麻醉学
- 儿科手术 儿科手术
- 疼痛管理 疼痛管理
背景情况:
- 持续的外周止痛疗法 (CEA) 有效地管理术后疼痛,但具有显著的副作用.
- 持续的外周神经阻塞 (CPNBs) 提供了一个可能减少不良事件和改善患者移动性的替代方案.
研究的目的:
- 为了比较持续的外周止痛 (CEA) 和持续的外周神经阻塞 (CPNBs) 在接受单方面下肢手术的儿科患者中.
- 关键结局包括吗啡毫克相当量 (MME),疼痛评分 (VAS),行走时间和不良事件率.
主要方法:
- 一个匹配的病例比较研究,涉及8至17岁的儿科患者,接受单边下肢手术.
- 41名患者接受CEA,36名患者接受CPNB. 排除标准包括慢性疼痛史,之前的下肢手术和发育迟缓.
主要成果:
- 两组之间在术后的MME,止痛救援需求或VAS疼痛得分方面没有发现显著差异.
- CEA组经历了更长的行走时间 (2.56 vs 1.89天) 和更高的低血压率.
- 与CPNB组相比,CEA组也显示出恶心,便秘,尿液保留和整体轻微不良事件的发生率显著更高.
结论:
- 在单方面下肢手术后,CPNB和CEA在儿科患者中提供相当的术后阿片类药物利用.
- 在这个研究群体中,CPNB与步行时间缩短和并发症率降低有关.
- 在特定的儿科整形外科病例中,CPNB可能是CEA的合适替代品,这需要在前性研究中进一步调查.
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