使用超声波导向编程间歇性勃起器脊柱平面块进行视频辅助胸腔镜叶切除术的周围手术止痛疗法的比较后期回顾
Xuefang Zhu1, Wei Ye1, Jinhong Chen1
1Department of Anesthesiology, The Fifth People's Hospital of Huan'an, No 1 Huaihe East Street, Huaiyin District, 223001, Huai'an City, Jiangsu Province, China.
BMC anesthesiology
|November 10, 2023
概括
超声导向勃起器脊柱平面阻塞 (ESPB) 使用编程间歇性玻尿酸 (PIB) 减少了阿片类药物使用和改善了与持续输液 (CI) 或标准麻醉相比,VATS手术后的疼痛控制. PIB还降低了局部麻醉剂毒性风险.
科学领域:
- 麻醉学 麻醉学
- 区域麻醉地区麻醉
- 胸部外科手术 胸部外科手术
背景情况:
- 视频辅助胸腔镜叶切除术 (VATS) 通常需要显著的阿片类药物止痛.
- 超声导向勃起器脊柱平面块 (美国导向ESPB) 是一种正在发展中的胸部止痛技术.
- 对比计划间歇性玻尿酸注射 (PIB) 和ESPB连续输液 (CI) 对于阿片类药物节约作用至关重要.
研究的目的:
- 为了比较美国指导的ESPB使用PIB与VATS患者的CI中的阿片类药物节约效应和副作用概况.
- 评估不同ESPB管理方法对术后疼痛和阿片类药物消费的影响.
主要方法:
- 一项回顾性队列研究包括180名VATS患者,随机分配到对照组,PIB-ESPB或CI-ESPB组.
- 主要结局是48小时内内和术后累积的阿片类药物消费.
- 疼痛评分 (NRS) 和血中levobupivacaine度是次要终点.
主要成果:
- 无论是PIB和CI组,都显示阿片类药物消费明显低于对照组 (p < 0.001).
- PIB还显示阿片类药物的使用量明显低于CI (p = 0.028).
- 在运动期间,PIB提供了更好的止痛效果,更广泛的感官阻断和更低的levobupivacaine水平,没有毒性.
结论:
- 美国指导的带有PIB的手术前ESPB有效地减少了阿片类药物需求,并增强了VATS后的止痛作用.
- 与CI相比,PIB提供了优势,包括更广泛的疼痛覆盖和降低局部麻醉毒性的风险.
- 美国指导的ESPB,特别是PIB,代表了胸部外科手术中一个有前途的阿片类药物节约策略.
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