在鼻腔手术中有效地使用局部麻醉剂:随机对照研究的系统审查和元分析
Leonardo Alaniz1,2, Cindy Vu1, Jagmeet Arora1
1From the School of Medicine, University of California Irvine, Irvine, Calif.
Plastic and reconstructive surgery. Global open
|August 3, 2023
概括
在鼻腔手术后,手术内神经阻塞显著减少疼痛和阿片类药物的使用. 患者报告了更高的满意度和更长的时间来首次止痛药,支持他们的最佳恢复的使用.
科学领域:
- 麻醉学和疼痛管理
- 术后恢复 术后恢复
- 基于证据的医学 基于证据的医学
背景情况:
- 术内神经阻塞正在成为管理鼻腔外科手术后疼痛的策略.
- 优化术后恢复是鼻腔手术管理的一个关键目标.
研究的目的:
- 系统地审查和元分析一级和二级关于鼻腔外科手术中的手术内神经阻塞的证据.
- 评估神经阻塞对术后疼痛,阿片类药物消耗和患者满意度的影响.
主要方法:
- 对PubMed,Embase和MEDLINE数据库进行系统审查和元分析.
- 包括四项研究,其中265名随机选择的患者.
- 使用逆变量,固定效应模型进行分析,使用科恩的d表示效应大小.
主要成果:
- 所有评估的神经阻塞 (脑外层,脑关节,外鼻腔,中面部,总体) 都显著减少了术后疼痛 (P < 0.001).
- 神经阻塞导致了较低的阿片类药物需求 (P < 0.001) 和更高的患者满意度 (P < 0.001).
- 接受神经阻塞的患者经历了更长的时间,第一次需要止痛药 (P < 0.001).
结论:
- 在鼻腔手术后,术后神经阻塞是有效的缓解鼻腔手术后的疼痛.
- 神经阻塞可以提高患者对疼痛管理的满意度.
- 建议考虑与全身麻醉一起进行外科手术期间的神经阻塞,以改善疼痛控制.
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