勃起器脊柱平面阻塞用于术后疼痛
Alexander Schnabel1, Stephanie Weibel2, Esther Pogatzki-Zahn1
1Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital Muenster, Muenster, Germany.
The Cochrane database of systematic reviews
|October 9, 2023
概括
勃起器脊柱平面阻塞 (ESPB) 可能为术后疼痛提供最小的益处,与没有阻塞相比,副作用很少. 需要进一步的研究来探索其止痛持续时间和有效性与其他区域麻醉技术相比.
科学领域:
- 麻醉学 麻醉学
- 区域麻醉地区麻醉
- 疼痛管理 疼痛管理
背景情况:
- 手术后的疼痛是一个重大的临床挑战,通常用阿片类药物和区域麻醉来管理.
- 勃起器脊柱平面阻塞 (ESPB) 是一种新兴的区域麻醉技术,有可能减少阿片类药物的使用和副作用.
研究的目的:
- 系统地比较ESPB的止痛疗效和安全性,与对照 (无阻塞,安慰剂) 和其他区域麻醉技术相比.
主要方法:
- 一项对64项随机对照试验 (RCT) 的元分析,涉及3973名成年手术患者.
- 主要结局包括24小时后休息后的术后疼痛和与阻断相关的不良事件.
- 使用Cochrane RoB 2工具评估偏差风险;使用GRADE评价证据的确定性.
主要成果:
- 在24小时后,ESPB可能会提供较小,临床上无意义的术后疼痛减轻,与没有阻断相比 (中度确定性证据).
- 在比较ESPB与安慰剂阻塞或其他技术,如椎阻塞 (PVB) 和横腹平面阻塞 (TAPB) (低至中等确定性证据) 时,没有观察到疼痛减轻的显著差异.
- 与区块相关的不良事件在所有比较中普遍较低,ESPB和对照组之间没有发现显著差异 (低确定性证据).
结论:
- 在加入标准护理时,ESPB可能不会显著改善24小时后的术后疼痛,与没有阻断相比.
- 与ESPB相关的与区块相关的不良事件的发生率很低.
- 需要进一步的研究来调查镇痛的持续时间和与其他区域麻醉方法相比的有效性.
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