区域麻醉在部保护手术中的有效性:系统性审查
Evan M Banks1, Jake A Ayisi2, Aliya G Feroe3
1Department of Orthopaedic Surgery, University of Minnesota Medical School, 2450 Riverside Ave Suite R200, Minneapolis, MN 55454, USA.
Journal of hip preservation surgery
|October 30, 2023
概括
外围神经阻塞显著减少关节透视术后的疼痛,但不是阿片类药物使用或住院. 对于其他关节手术,阻塞显示出希望,但由于样本大小小,需要更多的研究.
科学领域:
- 整形外科手术 整形外科手术
- 麻醉学 麻醉学
- 疼痛管理 疼痛管理
背景情况:
- 有效的术后疼痛管理对于部保护手术至关重要.
- 目前关于关节镜术,骨骨切除术和手术关节脱的疼痛控制的文献各不相同.
- 优化疼痛管理可以改善患者的治疗结果和恢复.
研究的目的:
- 系统地审查关于关节透视,关节骨折和手术关节脱的术后疼痛管理策略的文献.
- 评估不同疼痛控制方式的疗效,包括外围神经阻塞.
- 确定当前研究中的差距,并建议未来的方向.
主要方法:
- 对2000年1月至2022年12月期间发表的研究进行系统性文献综述.
- 包括随机对照试验,前性审查和涉及人类受试者的回顾性审查.
- 排除病例报告,动物研究和缺乏疼痛控制协议的研究.
主要成果:
- 外围神经阻塞在关节镜检查中显著降低了疼痛评分 (P=0.037),但没有显著影响阿片类药物的使用或停留时间.
- 对于周围骨切除术和手术部脱,周围神经阻塞显示疼痛,阿片类药物使用和住院减少,但统计学意义受到小样本大小的限制.
- 在审查的研究中,跌倒是最常见的并发症 (37%).
结论:
- 外围神经阻塞在关节镜术中有效减轻疼痛.
- 需要进一步研究更大的样本大小和标准化结果措施,以证实区域麻醉在周围骨骨切割和手术部脱的疗效.
- 研究结果的异质性需要更一致的研究来建立明确的疼痛管理协议.
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