在接受开放性胰腺切除术的患者的止痛方式-系统性审查和元分析
Simona Mărgărit1,2, Adrian Bartoș2,3, Laura Laza2
1Department of Anesthesia and Intensive Care, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.
Journal of clinical medicine
|July 29, 2023
概括
外周止痛疗法 (EA) 减少了手术后的疼痛,与胰腺切除术后的患者控制止痛疗法 (PCA) 相比. 连续的伤口透 (CWI) 和连续的双边胸部副脊椎输液 (CTPVI) 提供了与EA类似的疼痛缓解.
科学领域:
- 手术瘤学手术瘤学
- 疼痛管理 疼痛管理
- 麻醉学 麻醉学
背景情况:
- 胰腺切除术是一项重大手术,具有显著的术后疼痛.
- 有效的疼痛管理对于患者的康复和结果至关重要.
- 存在各种止痛方式,但它们的比较有效性需要系统的评估.
研究的目的:
- 系统地审查和比较不同止痛疗法在胰腺切除术后控制疼痛的疗效.
- 评估这些方式对术后结果的影响,包括住院时间和并发症.
主要方法:
- 在主要数据库 (PubMed,Embase,Web of Science,Scopus,Cochrane Library) 进行系统的文献搜索,遵循PRISMA指南.
- 包括随机对照试验和回顾性队列研究.
- 主要结局:术后1日和2日的疼痛评分. 二次结果:住院时间长度和与手术相关的并发症.
主要成果:
- 外周止痛疗法 (EA) 在术后第一天 (POD1) 和第二天 (POD2) 与患者控制止痛疗法 (PCA) 相比,显示疼痛得分明显较低.
- 在EA和连续伤口透 (CWI) 加PCA,或在POD1和POD2.2的连续双边胸部椎输液 (CTPVI) 之间,疼痛得分是可比的.
- 在研究的止痛药组中,没有观察到住院时间或与程序相关的并发症的显著差异.
结论:
- 外周止痛疗法 (EA) 比患者控制止痛疗法 (PCA) 更有效地减少胰腺切除术后的直接术后疼痛.
- 连续的伤口透 (CWI) 和连续的双侧胸部副脊椎输液 (CTPVI) 提供了与EA相似的疼痛缓解.
- 选择止痛方法并没有显著影响住院时间或并发症率.
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