超声导向勃起器脊柱平面块用于开放性腰椎片切除术后的疼痛管理
Jesse W Stewart1, Douglas Dickson2, Michael Van Hal2
1Department of Anesthesiology and Pain Management, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9068, USA. jesse.stewart@utsouthwestern.edu.
概括
勃起器脊柱平面阻塞 (ESPB) 在腰椎手术后显著减少疼痛和阿片类药物使用. 这种技术还减少了抗药的需要和麻醉后护理单位 (PACU) 停留时间.
科学领域:
- 麻醉学 麻醉学
- 疼痛管理 疼痛管理
- 脊柱外科手术 脊柱外科手术
背景情况:
- 腰椎手术往往会导致大量的术后疼痛.
- 勃起器脊柱平面块 (ESPB) 是一种区域麻醉技术,具有潜在的止痛效益.
- 作为腰椎片切除术多模式止痛的一部分,ESPB的有效性需要进一步研究.
研究的目的:
- 评估双边ESPB与多模式止痛药结合的止痛疗效.
- 为了比较接受ESPBs加多式联通止痛治疗的患者和仅接受多式联通止痛治疗的患者之间的结果.
- 评估ESPB对阿片类药物消费,疼痛评分和腰椎切除术后恢复指标的影响.
主要方法:
- 一项比较性研究涉及接受开放性腰椎片切除术的患者.
- 一组接受了手术前,双边,超声导向的ESPBs与标准化的多式联络止痛 (n=25).
- 对照组仅接受标准化的多模式止痛药 (n=25).
- 主要结局:24小时累积的阿片类药物消费. 二级结局:疼痛评分,抗使用,PACU和住院时间.
主要成果:
- 接受ESPBs的患者在24小时内显著减少了阿片类药物消费量 (31.9毫克与61.2毫克口服吗啡等价物相比).
- 在ESPB组,疼痛评分在PACU和直至术后第二天下降.
- 在ESPB组中,需要抗治疗的患者较少 (12%与48%),PACU持续时间较短 (49.7分钟与79.9分钟).
结论:
- 超声导向双边ESPB,作为多模式止痛的辅助,有效地减少阿片类药物消费和疼痛.
- 添加ESPBs减少了对抗治疗的需要,并缩短了腰椎片切除术后的PACU停留时间.
- ESPB是多模式止痛疗法的宝贵组成部分,用于优化腰椎手术后的康复.
更多相关视频
相关概念视频
01:11Local Anesthetics: Clinical Application as Spinal Anesthesia
677
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
677
01:29Local Anesthetics: Clinical Application as Epidural Anesthesia
458
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
458