消化管切除术中的止痛:一个叙述性回顾
Minke L Feenstra1,2,3,4, Mark I van Berge Henegouwen1,3,4, Markus W Hollmann2
1Department of Surgery, Amsterdam UMC location AMC, University of Amsterdam, Amsterdam, The Netherlands.
Journal of thoracic disease
|October 23, 2023
概括
在食道切除术后,最佳的疼痛管理至关重要. 虽然外周止痛是标准的,但椎止痛提供了一个更安全的替代方案,勃起器脊柱平面块需要进一步研究以控制食道切除术疼痛.
科学领域:
- 麻醉学和疼痛管理
- 胸部外科手术 胸部外科手术
- 手术瘤学手术瘤学
背景情况:
- 消化管切除术后有效的疼痛管理对于预防肺炎和慢性疼痛等并发症至关重要.
- 历史上,静脉注射止痛药被使用,但区域麻醉技术已经成为突出的.
- 外周止痛疗法 (EA) 被认为是黄金标准,但人们对严重的神经系统并发症表示担忧.
研究的目的:
- 为在食道切除术中使用的不同止痛疗法提供全面的证据概述.
- 为了比较各种疼痛管理策略的有效性和安全性.
- 确定未来对食道切除术疼痛控制的研究领域.
主要方法:
- 对食道切除术的止痛疗法研究的叙述性综述.
- 在2022年11月在PubMed/MEDLINE进行文献搜索.
- 包括英语或荷兰语的报告,不包括没有完整文本的社论和文章.
主要成果:
- 外周止痛疗法 (EA) 可能减少肺炎和慢性术后疼痛 (CPSP),但会带来神经系统并发症的风险.
- 准脊椎镇痛 (PVA) 是一种安全有效的EA替代品,可以更轻松地放置导管.
- 勃起器脊柱平面阻塞 (ESPB) 显示出潜力,但需要更多关于其在食道切除术中的有效性的证据.
结论:
- 副脊椎止痛是一种可行的替代品,用于治疗食道切除术疼痛的外周止痛.
- 需要进一步的随机临床试验来评估准脊椎和直立脊柱平面块的疗效.
- 通过区域麻醉技术优化疼痛管理是改善食道切除术后患者结果的关键.
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