区域麻醉在跨阴道食道切除术中的使用. 他们值得考虑吗? 一个案例系列
William Mitchell1, Thomas Roser1, Jessica Heard2
1Burnett School of Medicine at Texas Christian University, Fort Worth, TX, USA.
Local and regional anesthesia
|July 17, 2023
概括
横腹平面 (TAP) 块促进食道切除术后的早期输出,改善了患者的治疗结果. 这项技术为胸部外周止痛提供了替代方案,减少了并发症和住院时间.
科学领域:
- 麻醉学 麻醉学
- 胸部外科手术 胸部外科手术
- 疼痛管理 疼痛管理
背景情况:
- 消化管切除术与高的术后发病率和死亡率有关.
- 胸腔外周止痛疗法 (TEA) 是术后疼痛的标准,但可能导致并发症.
- 消化管切除术后的早期输出改善了患者的治疗结果.
研究的目的:
- 评估横腹平面 (TAP) 块对食道切除术后输出管率的影响.
- 评估TAP阻塞作为TEA的替代物用于术后止痛.
主要方法:
- 一个由42名患者组成的病例系列,在2019-2022年期间接受过腔食道切除术.
- 患者接受了没有TEA的TAP阻断剂.
- 主要结局包括在手术室内 (OR) 的输出管和再输入管率.
主要成果:
- 81%的患者在手术室进行了输管.
- 21.4%的患者需要重新输管.
- 住院时间 (LOS) 的中位数分别为5天和10天.
- 对于关键结果,单独的TAP区块与附加区块 (TAP+) 的TAP区块可比.
结论:
- 在食道切除术后,TAP阻塞能够立即进行输出.
- 这种技术限制了手术后的低血压和液体输入.
- 在食道切除术患者中,TAP阻塞是一种可行的初级止痛替代品.
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