视频辅助胸腔镜外科手术中超声导向的副脊柱阻塞的麻醉传播:一个三维重建图像研究
Qi Chen1, Han Yang2, Daqiang Zhao3
1Department of Anesthesiology, Chongqing University Cancer Hospital, Chongqing, China.
Pain physician
|August 3, 2023
概括
交叉过程块 (ITPB) 与勃起器脊柱平面块 (ESPB) 相比,为胸壁麻醉提供了优越的前部和侧部扩散. 然而,ESPB提供了更好的头尾部扩散,表明这些区域麻醉技术的不同临床应用.
科学领域:
- 区域麻醉地区麻醉
- 胸部外科手术 胸部外科手术
- 疼痛管理 疼痛管理
背景情况:
- 超声波引导的副脊柱阻塞的麻醉扩散仍然不完全理解.
- 进行交叉过程块 (ITPB) 和直立脊柱平面块 (ESPB) 的扩散特性比较对于临床应用至关重要.
研究的目的:
- 在临床实践中比较交叉过程块 (ITPB) 和勃起脊柱平面块 (ESPB) 的药物扩散特性.
- 用CT-3D重建评估ITPB和ESPB之后局部麻醉剂传播的程度和模式.
主要方法:
- 一项前性研究,涉及20名接受胸腔镜肺部手术的患者.
- 患者接受了ITPB或ESPB与布皮瓦卡因和iohexol.
- 计算机断层扫描 (CT) 三维 (3D) 重建被用于分析术后药物扩散模式.
主要成果:
- 与ESPB相比,ITPB表现出明显改善的前部和侧部扩散 (100%在准脊椎和肋间空间),分别为20%和30%.
- 与ITPB (4.5个细分) 相比,ESPB显示了增强的头尾部分布 (10个细分).
- 临床评估显示,ITPB患者的侧侧和前侧胸壁有更广泛的感觉损失.
结论:
- ITPB为侧侧和前侧胸壁阻塞提供了更大的稳定性,并改善了扩散到肋间间空间的情况.
- ESPB提供优越的头尾部扩散,根据所需的麻醉覆盖范围,建议不同的适应症.
- 需要进一步的临床试验,采用更大的样本大小来验证这些发现.
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