直肠膜块改善了患者在开放性大动脉手术后的康复
Colin Cleary1, Ya-Huei Li2, Akhilesh Jain3
1University of Connecticut School of Medicine, Farmington, CT.
Annals of vascular surgery
|December 6, 2023
概括
辅助直肠膜封锁 (RSB) 显著减少阿片类药物的使用和停留时间的患者接受开放性大动脉手术 (OAS). RSB为术后疼痛管理提供了有效的替代方案,改善了患者的康复.
科学领域:
- 麻醉学 麻醉学
- 血管外科 血管外科
- 疼痛管理 疼痛管理
背景情况:
- 手术后的疼痛是大动脉手术后恢复的一个重大挑战.
- 外周导管用于治疗疼痛,但直肠块 (RSB) 的研究较少.
- 这项研究比较了带有RSB和没有RSB的腹腔大动脉开放手术 (OAS) 的康复结果.
研究的目的:
- 为了评估直肠膜阻塞作为开放性大动脉手术的辅助疼痛管理策略的有效性.
- 为了比较单独的全身麻醉 (GA) 和带有RSB的GA之间的患者康复指标.
主要方法:
- 接受腹部大动脉动脉瘤开放修复或旁路的成年患者被分为全身麻醉 (GA) 或GA + RSB组.
- 排除标准包括外周止痛和后修复.
- 测量结果:输出时间,阿片类药物利用 (MME),停留时间和并发症.
主要成果:
- 接受GA + RSB治疗的患者表现出更短的输出时间 (P < 0.001),以及手术后 (P = 0.002) 和出院时 (P = 0.036) 的减少MME利用率.
- 此外,RSB组的逗留时间更短 (P = 0.006),选择性程序的比例更高.
- 术后并发症在各组之间是可比的.
结论:
- 辅助直肠外阻塞可以在开放性大动脉手术期间和之后减少阿片类药物消耗.
- 在OAS中,RSB是周围手术止痛的可行替代品,可以改善患者的康复.
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