[在微创胸部手术中进行术后疼痛治疗]
Katharina Bach1, Christian Volberg2, Thomas Wiesmann2,3
1Klinik für Anästhesie und Intensivtherapie, Universitätsklinikum Marburg, Philipps-Universität Marburg, Baldingerstraße, 35043, Marburg, Deutschland. bachka@staff.uni-marburg.de.
Die Anaesthesiologie
|September 19, 2023
概括
在胸部手术中,管理术后疼痛至关重要. 本综述检查了当前的指导方针和区域麻醉技术,如对脊椎和直立脊柱平面块用于胸腔镜手术.
科学领域:
- 麻醉学和疼痛管理
- 胸部外科手术 胸部外科手术
- 区域麻醉地区麻醉
背景情况:
- 胸部手术经常导致严重的术后疼痛,影响患者的康复,并可能导致并发症.
- 虽然外周麻醉是胸腔切除术的传统标准,但在视频辅助胸腔镜中,其益处风险比率受到质疑.
- 胸间神经刺激,压缩或损伤,以及胸管放置,是胸部手术中常见的疼痛来源.
研究的目的:
- 为了总结当前的术后疼痛管理推对于胸腔镜手术.
- 提供PROSPECT和AWMF关于胸部手术疼痛治疗的指导方针的概述.
- 审查用于胸腔镜手术的个人区域麻醉技术的证据.
主要方法:
- 审查当前的文献和临床指南.
- 分析了PROSPECT (手术后特殊疼痛管理) 倡议的建议.
- 德国科学医学协会协会 (AWMF) 准则的审查.
- 对特定胸部区域麻醉技术的证据评估.
主要成果:
- 对于其他胸部阻塞,如椎阻塞,直立脊柱平面阻塞和前阻塞,存在异质的结果.
- 这篇文章批判地评估了这些替代区域麻醉技术的证据基础.
- 目前的指导方针为优化胸腔镜手术中的疼痛管理提供了一个框架.
结论:
- 适当的术后疼痛治疗对于预防诸如胸部手术后呼吸不足等并发症至关重要.
- 替代胸部阻塞是有希望的,但需要仔细考虑其证据基础和益处风险概况.
- 本综述帮助临床医生根据当前的证据和指导方针,选择适合胸腔镜手术的区域麻醉技术.
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