带有准脊椎阻塞的区域麻醉与接受微型心脏切除术心脏手术的患者的改善结果有关
Monica Hsieh1, Diane Kim2, Defen Peng3
1Department of Anesthesiology, Pharmacology, and Therapeutics, University of British Columbia, Vancouver, BC, Canada.
Innovations (Philadelphia, Pa.)
|August 16, 2023
概括
副脊柱导管 (PVC) 区域麻醉在微创心脏手术患者中减少了阿片类药物的使用和住院时间. 这种方法可以降低阿片类药物依赖的风险.
科学领域:
- 麻醉学 麻醉学
- 心脏外科手术 心脏外科手术
- 疼痛管理 疼痛管理
背景情况:
- 在微创心脏手术 (MICS) 后,严重的术后疼痛是常见的.
- 使用副脊柱导管 (PVC) 的区域麻醉可以减少胸切割切口的疼痛.
- 关于MICS中PVC的安全性和有效性的数据有限.
研究的目的:
- 评估准脊柱导管 (PVC) 在MICS患者的疼痛管理中的有效性.
- 为了比较PVC和对照组之间的阿片类药物使用和住院时间 (LOS).
- 在MICS患者中确定术后阿片类药物使用的风险因素.
主要方法:
- 对123名MICS患者 (2016-2019) 的回顾性审查.
- 组:常规系统性止痛 (对照组,N=54),副脊椎导管 (PVC,N=53),其他区域性止痛 (非PVC,N=16).
- 主要结局:外科手术期间使用阿片类药物和医院LOS. 使用回归模型进行统计分析.
主要成果:
- PVC组的医院LOS (5.8天) 与对照组 (8.3天) 和非PVC (6.6天) 组相比显著更短 (P=0.033).
- 与对照组 (24.5%) 和非PVC (37.5%) 组 (P=0.043) 相比,PVC患者中避免术后使用氧化的比例更高 (48.1%).
结论:
- 副脊柱导管 (PVC) 区域麻醉与减少阿片类药物需求和在MICS中更短的住院时间有关.
- 术后阿片类药物使用的减少可能会降低阿片类药物依赖的风险.
- 需要进一步的随机对照试验来证实这些发现.
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