在心脏外科手术中进行椎切割后,用于术后止痛的深度副侧侧侧椎间盘间平面块 - - 一个回顾性队列研究
Alexander J Skojec1, Jon M Christensen1, Suraj M Yalamuri1
1Department of Anesthesiology and Perioperative Medicine, Division of Cardiothoracic Anesthesia, Mayo Clinic College of Medicine and Science, Rochester, MN.
Journal of cardiothoracic and vascular anesthesia
|November 15, 2023
概括
手术后的深部副侧侧肋间平面 (DPIP) 阻塞显著减少了60%的阿片类药物消耗,并改善了心脏手术患者的疼痛评分. 这种技术为中枢椎切除术恢复提供了一个有前途的止痛策略.
科学领域:
- 麻醉学 麻醉学
- 心脏外科手术 心脏外科手术
- 疼痛管理 疼痛管理
背景情况:
- 用于心脏手术的中枢骨切割通常会导致显著的术后疼痛.
- 有效的疼痛管理对于患者的康复和减少并发症至关重要.
研究的目的:
- 为了评估术后深侧侧肋间平面 (DPIP) 块的止痛效果.
- 评估DPIP阻断对阿片类药物消费和心脏手术后疼痛评分的影响.
主要方法:
- 一项回顾性研究比较了接受双边DPIP阻塞的113名患者和3,461名对照患者.
- 经过超声导向的双边DPIP阻塞是在术后进行的.
- 在前24小时和手术后的0日和1日分析了阿片类药物消耗和疼痛评分.
主要成果:
- 接受DPIP阻塞的患者使用的阿片类药物减少了60% (乘法变化为0.42,p < 0.001).
- 在术后的第0天 (OR 0.46,p < 0.001) 和第1天 (OR 0.67,p = 0.021) 观察到明显较低的疼痛评分.
- 一项探索性分析表明,在接受DPIP阻塞的患者中,心房的发病率降低了 (2%vs15%).
结论:
- 手术后的DPIP阻断与减少阿片类药物需求和改善中枢椎切除术后的疼痛控制有关.
- DPIP阻塞也可能与术后心房的发病率较低有关.
- 建议进行进一步的随机对照试验,以确认疗效和安全性.
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