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胸腔镜指导多重准脊椎阻断在视频辅助胸腔镜叶切除手术中的有效性和安全性:一项随机盲控研究

Zhixiong Li¹, Qingshui Lin¹, Liangqing Lin¹

¹Department of Anesthesiology, The School of Clinical Medicine Fujian Medical University, The First Hospital of Putian, Putian, China.

Frontiers in surgery

|November 9, 2023

概括

在视频辅助胸腔镜叶切除术 (VATS LOBECTOMY) 中,胸腔镜引导的副脊椎阻断 (PVB) 有效减少了手术内阿片类药物的使用和术后疼痛. 这种技术改善了恢复,减少了不良事件,使其成为多式联络止痛的宝贵组成部分.

科学领域:

麻醉学麻醉学
胸部外科手术胸部外科手术
疼痛管理疼痛管理

背景情况:

准脊椎阻塞 (PVB) 越来越多地用于术后疼痛.
对于视频辅助胸腔镜叶切除术 (VATS LOBECTOMY) 中手术内和手术后疼痛的胸腔镜辅助多重PVB存在有限的研究.

研究的目的:

评估胸腔镜导向多重PVB在VATS LOBECTOMY期间和之后的疼痛治疗的疗效和安全性.

主要方法:

120名接受VATS LOBECTOMY的患者随机分为安慰剂 (n=40) 和PVB (n=80) 组.
胸腔镜引导的多点PVB与ropivacaine在手术开始和结束时进行.
主要终点是手术期间服用阿片类药物.

主要成果:

在PVB组显示显著降低了手术内阿片类药物消费 (雷米芬坦尼尔和芬太尼尔).
PVB患者经历了更长的第一次患者控制的静脉静脉止痛使用,更少的止痛压力,以及更少的救援止痛使用.
在手术后48小时内,在PVB组中观察到较低的视觉模拟尺度得分,更高的恢复质量-40分,以及较少的不良事件.

结论:

胸腔镜导向多重PVB是一种简单,有效的方法,用于在VATS LOBECTOMY中控制手术内和术后的疼痛.
这种技术避免了与阿片类药物相关的不良影响,并促进了活动和身体功能的早期恢复.
应将PVB视为VATS LOBECTOMY多模式止痛的关键组成部分.

关键词:

早期的术后止痛.在手术期间使用手术内止痛药.抗阿片类药物缓解效应的阿片类药物缓解效应术后康复质量术后康复质量胸腔镜引导的副脊椎阻塞视频辅助的胸腔镜叶片切除术

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