在过去的十年里,术后止痛在开放式和微创胸部手术中的发展
Klara Schwarzova1, Glenn Whitman2, Stephanie Cha2
1Ascension Saint Agnes Hospital, Baltimore, Maryland.
Seminars in thoracic and cardiovascular surgery
|October 2, 2023
概括
胸部手术后有效的疼痛管理使用多模式止痛,结合区域阻断和阿片类药物节约药物. 这种方法可以改善患者的康复,并减少住院时间.
科学领域:
- 麻醉学和疼痛管理
- 胸部外科手术 胸部外科手术
- 术后护理 术后护理
背景情况:
- 胸部手术是非常痛苦的,因为肌肉切割,肋骨切除和排水.
- 疼痛控制不良会导致严重的并发症,如长时间的ICU住院和慢性疼痛.
研究的目的:
- 审查当前的胸部手术疼痛管理策略.
- 强调多模式止痛和增强恢复途径.
主要方法:
- 2010-2022年出版的文章的文献评论来自PubMed和谷歌学者.
- 关键词:胸部,心脏,疼痛控制,外围止痛,带平面阻塞,多式止痛,手术后增强恢复.
- 包括53项研究 (临床试验,病例系列,队列研究).
主要成果:
- 多模式麻醉结合了区域技术 (表皮外围,面带平面阻塞) 与阿片类药物节约剂 (乙氨基, gabapentin).
- 这种组合提供了足够的疼痛控制,减少了阿片类药物的使用,并缩短了住院时间.
- 个性化止痛计划对于患者的康复至关重要.
结论:
- 多模式止痛是胸部手术疼痛管理的黄金标准.
- 需要进一步的研究来优化止痛药和区域技术的组合.
- 改善疼痛管理可以改善患者的治疗结果和恢复.
相关概念视频
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
106
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
106
Peripheral Artery Disease V: Postoperative Nursing Management
12
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
12
Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques
19
Airway management is essential in emergency and surgical medicine, ensuring ventilation and oxygenation in patients who cannot maintain their own airway. Clinicians use a range of techniques and devices to secure the airway, depending on the patient’s condition and the clinical context. Key methods include endotracheal intubation, rapid sequence intubation (RSI), supraglottic airway devices, and advanced visualization aids. In cases where these approaches fail, surgical airway...
19
General Anesthesia: Overview
237
Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
237
Endoscopic Studies II: Thoracocentesis
312
Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
312
Aneurysm IV: Nursing Management
8
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
8


