痛:对外围神经进行审查
Benjamin R Slavin1, Moses I Markowitz1, Kevin M Klifto2
1Division of Plastic Surgery, University of Miami Miller School of Medicine, Miami, Florida.
Journal of reconstructive microsurgery
|September 26, 2023
概括
痛疗法提供了一种安全有效的方法,通过暂时中断周围神经功能来管理慢性疼痛. 这种技术,特别是在胸切除术后的肋间间神经,可以减少手术后的疼痛和阿片类药物的使用,而不会损害神经.
科学领域:
- 干预性放射学是干预性的放射学.
- 疼痛管理 疼痛管理
- 外周神经手术是指外周神经的手术.
背景情况:
- 慢性疼痛疗法是一种干预性放射技术,用于慢性疼痛管理.
- 它暂时中断了周围神经的功能,但没有引起神经瘤的形成.
- 它在外围神经外科手术中的应用并未被重建性微型外科医生广泛理解.
研究的目的:
- 为了审查由冷应用引起的神经损伤的组织病理学.
- 为了比较手术内冷静止痛与胸部外周麻醉在胸切除术后术后疼痛的疗效.
- 为了评估对神经痛的冷疼痛.
主要方法:
- 对PubMed和MEDLINE数据库进行比较研究的文献综述.
- 分析了16项关于肋间神经慢性疼痛症的临床研究.
- 使用费舍尔的精确和ANOVA测试进行统计分析.
主要成果:
- 在九项研究中,有七项研究表明,痛疗法显著减少了术后阿片类药物使用或胸切除术后的疼痛评分.
- 与局部麻醉剂相比,cryoanalgesia表现出显著的急性疼痛减轻.
- 在比较痛疗法与外周止痛疗法时,没有发现疼痛或阿片类药物使用的显著差异.
- 干预性放射学指导的 pudendal cryoanalgesia 显示了 pudendal神经疼痛的积极结果.
结论:
- 低温痛解为外围神经功能提供了"重置",而无需切除.
- 术内对肋间神经的冷静止痛是安全有效的,用于术后的胸腔切除术后的术后止痛.
- 低温痛解可以为尾神经损伤提供临床缓解,保持神经功能.
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