超声导向的前额头上神经阻塞与关节镜肩部手术的间层臂阻塞:一项随机对照研究
Kapil Gupta1, Malvika Gupta2, Nikki Sabharwal1
1Department of Anaesthesia and Critical Care, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Indian journal of anaesthesia
|August 21, 2023
概括
超声引导的上神经阻塞 (SSB-A) 提供了类似的疼痛缓解,为肩膀外科手术中间神经阻塞 (ISB),但更好地保留了腹膜和肺功能.
科学领域:
- 麻醉学 麻醉学
- 区域麻醉地区麻醉
- 疼痛管理 疼痛管理
背景情况:
- 间层臂阻塞 (ISB) 由于神经的干扰,可以导致半腹膜 (HDP).
- 通过前方方法 (SSB-A) 阻断上神经是一种较远端的阻断,可能会节省神经.
研究的目的:
- 为了比较超声波引导的SSB-A与ISB在关节镜肩部手术中的止痛效果和对隔膜功能的影响.
主要方法:
- 60名接受关节镜肩部手术的患者接受了美国指导的SSB-A或ISB与布皮瓦卡因和甲.
- 主要结局:镇痛的持续时间. 二级结局:术后疼痛评分,吗啡消耗,隔膜外流 (HDE) 和肺功能测试 (PFT).
主要成果:
- 在SSB-A (1345±182分钟) 和ISB (1375±156分钟) 之间,镇痛的持续时间相似.
- 与ISB (44%) 相比,SSB-A (10%) 的 Hemi-diaphragmatic 游览减少明显较小.
- 肺功能在SSB-A组中得到更好的保护.
结论:
- 在关节镜肩部手术中,SSB-A提供了与ISB相似的止痛效果.
- 在保护隔膜和肺功能方面,SSB-A优于ISB.
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