术前胸腔外周试验策略的有效性:回顾性比较三种常用的试验方法
Hermann Dos Santos Fernandes1,2, Naveed Siddiqui3, Sharon Peacock3
1Department of Anesthesia and Pain Management, Mount Sinai Hospital - Sinai Health, Toronto, ON, Canada. hermann.dossantosfernandes@sinaihealth.ca.
概括
对胸部外周止痛安置 (TEA) 的客观手术前检测显著降低了失败率. 与传统测试相比,更新的方法,如外周电刺激试验 (EEST) 和外周压力波形分析 (EWA),可以改善结果.
科学领域:
- 麻醉学和疼痛管理
- 手术技巧 手术技巧
- 医疗器械评估 医疗器械评估
背景情况:
- 胸腔外围止痛 (TEA) 对于在重大胸腔和腹部手术期间控制疼痛至关重要.
- 目前用于验证TEA导管放置的方法,如局部麻醉温度解离试验 (LATDT),有相当大的失败率.
- 目标,新的技术,如外周电刺激试验 (EEST) 和外周压力波形分析 (EWA),旨在改善放置验证.
研究的目的:
- 评估手术前胸腔外周止痛导管测试方法 (LATDT,EEST和EWA) 在降低TEA失败率方面的有效性.
- 为了比较经过测试的与未经测试的胸部外周支架安置的失败率.
主要方法:
- 一项回顾性研究审查了在2016年至2021年期间接受TEA的1241名患者.
- 患者被分为四组:没有测试,LATDT,EEST或EWA用于验证导管放置.
- 治疗TEA的成功被定义为双边皮肤体感官阻断和术后至少24小时的使用.
主要成果:
- 胸部外周止痛药的整体失败率在经过测试的外周止痛药 (3.8%) 与未经测试的外周止痛药 (11.5%) 相比显着较低.
- 这一差异是统计学上显著的 (P < 0.001).
结论:
- 胸腔外围导管安置的客观手术前检测与失败率的降低有关.
- 实施像EEST和EWA这样的客观测试方法可以提高胸部外周止痛的成功率.
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