双边大尾神经堵塞;远距离与近距离的方法用于腹腔穿刺后头痛:一项随机临床试验
Amir Abouzkry Elsayed1, Taha Tairy Dardeer Elsawy2, Ahmed Elsaied Abdul Rahman3
1Department of Anesthesia and Surgical Intensive Care, Kafrelsheikh University, Kafrelsheikh, Egypt.
Pain physician
|September 29, 2023
概括
超声导向的近接大尾神经阻塞 (GONB) 与远端GONB相比,可以提供优越的疼痛缓解,以缓解腹痛后刺痛 (PDPH). 靠近的GONB显著降低了PDPH患者的疼痛评分和药物使用.
科学领域:
- 麻醉学和疼痛管理
- 神经学 神经学
- 超声指导程序 超声指导程序
背景情况:
- 产后刺痛头痛 (PDPH) 是神经轴麻醉后的一个常见并发症.
- 大尾神经阻塞 (GONB) 是PDPH的有效和快速治疗方式.
- 超声波 (US) 指导提高了GONB的精度和安全性.
研究的目的:
- 为了比较远距离与近距离超声波 (美国) 引导的双边大尾神经阻塞 (GONBs) 的缓解疼痛的疗效,用于治疗持续性刺伤后头痛 (PDPH).
- 为了评估PDPH患者接受不同的GONB技术的疼痛减轻和止痛药消耗.
主要方法:
- 一项随机双盲研究,涉及50名被诊断患有PDPH的患者 (数值评分表[NRS-11] ≥4).
- 患者被随机分为两组:D组接受美国指导的远端双边GONB,P组接受美国指导的近端双边GONB.
- 两组人都通过双边GONBs接受了3毫升0.5%的异巴克布皮瓦卡因和4毫克德克萨米.
主要成果:
- 美国指导的远端和近端GONB均显著降低了躺和坐姿的疼痛评分 (NRS-11).
- 在所有测量中,近端GONB组 (P组) 与远端组 (D组) 相比,表现出明显较低的坐着NRS-11得分.
- 与D组相比,P组在48小时内消耗的青和青明显较低 (P=0.038和0.036).
结论:
- 超声导向的近端和远端GONB是PDPH的最小侵入性,简单和有效的治疗方法.
- 靠近的GONB在缓解PDPH症状和减少救援止痛药的需要方面表现出优于远端GONB的优势.
- 建议使用更大的样本大小进行进一步的研究,以确认二次结果.
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