区域麻醉和儿科患者的状细胞危机:以教育为重点的审查
Amr Elhamrawy1, Giorgio Veneziano1,2, Joseph D Tobias1,2
1Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA.
Paediatric anaesthesia
|November 20, 2023
概括
区域麻醉可以帮助管理状细胞疾病 (SCD) 疼痛危机,可能避免阿片类药物的副作用. 需要更多的研究来制定SCD患者这些技术的指导方针.
科学领域:
- 麻醉学 麻醉学
- 血液学 血液学 血液学
- 疼痛管理 疼痛管理
背景情况:
- 状细胞病 (SCD) 是一种常见的遗传性血液疾病,影响全球数百万人.
- 在SCD中血管封闭性危机 (VOC) 疼痛主要通过全身阿片类药物进行管理.
- 阿片类药物治疗带有风险,如呼吸系统抑郁和低氧化.
研究的目的:
- 审查现有的关于在状细胞病患者中使用区域麻醉的文献,这些患者经历了疼痛危机.
- 评估区域麻醉技术作为SCD疼痛阿片类药物治疗的替代方案或辅助方案的潜在好处和局限性.
主要方法:
- 使用PubMed,Scopus和谷歌学者进行了系统的文献搜索.
- 关键词包括状细胞病,疼痛危机,血管闭塞危机,区域麻醉,外围神经阻塞和神经轴向麻醉.
- 出版物被确定和审查,以确定它们与SCD区域麻醉的相关性.
主要成果:
- 七篇出版物详细介绍了26名SCD患者的神经轴麻醉的情况.
- 四个出版物描述了VOCSCD患者的外周神经阻塞.
- 所有确定的研究都是追溯的案例系列或单个案例报告.
结论:
- 现有文献表明,区域麻醉可能对SCD的疼痛管理有好处.
- 潜在的优势包括避免阿片类药物相关的不良影响和改善呼吸功能.
- 缺乏前性试验限制了基于证据的指导方针,用于SCD的最佳区域麻醉技术.
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