与全身麻醉相比,手臂阻断后的反弹疼痛和术后疼痛概况 - 一项观察性研究
Ann-Kristin Schubert1, Thomas Wiesmann1,2, Christian Volberg1
1Department of Anaesthesiology and Intensive Care Medicine, University Hospital Marburg, Philipps University of Marburg, Marburg, Germany.
区域麻醉 (RA) 提供初始疼痛缓解,但可能导致反弹疼痛. 这项研究发现,手手术后的RA与全身麻醉 (GA) 相比,没有增加整体疼痛或阿片类药物的使用.
科学领域:
- 麻醉学 麻醉学
- 疼痛管理 疼痛管理
- 术后恢复 术后恢复
背景情况:
- 区域麻醉 (RA) 旨在减少全身止痛和副作用.
- 在RA之后的术后反弹疼痛可能需要使用阿片类药物,可能会否定最初的益处.
- 了解臂麻醉 (RA) 与全身麻醉 (GA) 后的反弹疼痛对于优化疼痛管理至关重要.
研究的目的:
- 与全身麻醉 (GA) 相比,在手臂麻醉 (RA) 后描述术后疼痛概况.
- 为了研究随意手和前臂手术后的RA后反弹疼痛的现象.
主要方法:
- 一个单一中心的观察性分层队列研究,涉及132名接受选手/前臂手术的患者.
- 患者接受了超声导向的臂麻醉 (RA) 或全身麻醉 (GA).
- 主要终点是24小时内综合疼痛评分 (IPS);次要终点包括疼痛评分,阿片类药物消耗和患者满意度.
主要成果:
- 在手术后立即和在麻醉后护理单元 (PACU) 中,RA组的综合疼痛评分 (IPS) 显着较低.
- 在手术后3小时内,RA和GA组之间的疼痛分数在病房内均等.
- 没有发现阿片类药物消费或反弹疼痛超标的显著增加;患者满意度和康复程度相似.
结论:
- 虽然RA的初始疼痛较低,但随着阻断的消失,疼痛得分与GA相等.
- 在RA后的反弹疼痛并没有抵消其阿片类药物节约作用,也没有导致与GA相比整体疼痛增加.
- 在这项研究中,没有观察到反弹疼痛的不良临床影响.
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