利多卡因用于预防慢性腹腔内血瘤栓塞期间的头痛
Francesco Diana1,2, Michele Romoli3, Francesca Ricchetti4
1Interventional Neuroradiology, Vall d'Hebron University Hospital, Barcelona, Spain.
概括
在中脑膜动脉栓塞 (MMAE) 之前用乙烯乙烯醇 (EVOH) 进行动脉内利多卡因 (IAL) 治疗,可显著降低慢性亚皮血瘤 (CSDH) 治疗期间的疼痛. 这种方法也改善了患者的遵守,提供了更安全,更舒适的程序.
科学领域:
- 干预性神经放射学 干预性神经放射学
- 疼痛管理 疼痛管理
- 神经外科 神经外科
背景情况:
- 慢性亚皮血瘤 (CSH) 管理通常涉及使用乙烯乙烯醇 (EVOH) 的中脑膜动脉栓塞 (MMAE).
- 带有EVOH的MMAE可能会由于脑膜 nociceptor刺激而引起患者显著的不适.
- 评估在MMAE期间减轻疼痛的方法对于患者的福祉和治疗坚持至关重要.
研究的目的:
- 评估静脉内利多卡因 (IAL) 在CSDH的MMAE之前的安全性和有效性.
- 为了确定IAL是否可以减少患者在EVOH栓塞过程中所经历的疼痛.
- 评估IAL对患者在手术过程中遵守程序的影响.
主要方法:
- 一项病例控制研究分析了连续接受双边CSDHMMAE与EVOH的双边CSDH患者.
- 单侧静脉内利多卡因 (IAL) 注射是随时分配的.
- 在栓塞过程中使用视觉模拟量表 (VAS) 评估疼痛,将IAL治疗侧与对照侧进行比较.
- 统计分析包括配对的t测试和千平方测试,遵循STROBE指南.
主要成果:
- 在2021年9月至2023年3月期间,32名双边CSDH患者接受了MMAE与EVOH.
- 与对照组相比,IAL治疗导致VAS得分明显降低 (中位数为3) (中位数为7,p < 0.001).
- 没有观察到任何实质性的副作用,患者对利多卡因的服药性有所改善.
结论:
- 动脉内利多卡因 (IAL) 似乎有效地减少了与CSDH的MMAE期间EVOH注射相关的疼痛.
- 在这种干预过程中,IAL的使用可能会提高患者在干预过程中的服从性.
- IAL代表了一种潜在的有价值的补充,可以改善CSDH的MMAE患者的舒适度.
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