视频辅助胸腔镜手术的副脊椎和外周麻醉:一个随机试验
Zixiang Wu1, Qi Wang1, Cong Wu2
1Department of Thoracic Surgery, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
The Annals of thoracic surgery
|August 13, 2023
概括
副脊椎阻塞 (PVB) 提供类似的疼痛缓解胸部外周止痛疗法 (TEA) 胸腔镜手术. PVB还具有较短的导管放置时间和较少的副作用,使其成为术后疼痛管理的有益选择.
科学领域:
- 麻醉学 麻醉学
- 胸部外科手术 胸部外科手术
- 疼痛管理 疼痛管理
背景情况:
- 胸腔镜手术后的术后疼痛管理仍然是一个临床挑战.
- 准脊椎阻塞 (PVB) 与胸部外周止痛疗法 (TEA) 对中度至重度急性疼痛的疗效仍在争论中.
研究的目的:
- 在接受胸腔镜手术的患者中,将副脊椎阻塞 (PVB) 与胸部外周止痛 (TEA) 的益处进行比较.
主要方法:
- 一项随机对照试验,涉及176名接受胸腔镜手术的患者.
- 患者被分配到PVB或TEA组中.
- 使用视觉模拟尺度 (VAS) 评估疼痛,在休息和咳期间.
主要成果:
- 在休息或咳时的PVB和TEA组之间没有观察到VAS得分的显著差异.
- 与TEA相比,PVB显示了与TEA相比的中位导管放置时间 (5分钟 vs. 14分钟) 显著缩短.
- PVB组显示了较低的导管放置失败率和降低低血压和尿液保留的发生率.
结论:
- 准脊椎阻塞在胸腔镜手术中提供了与胸部外周止痛疗法相比较的疼痛缓解.
- 与TEA相比,PVB提供了优势,包括缩短了手术时间,降低了并发症率,并且没有额外的穿孔疼痛.
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