在心脏植入器件手术过程中使用超声波引导的胸部神经块
Neel A Patel1, David Lin1, Bao Ha2
1Cardiac Electrophysiology, University of Pennsylvania, Philadelphia, PA, USA.
概括
电生理学家可以在心脏植入式电子设备 (CIED) 程序期间可行地执行胸部神经 (PEC) 阻塞. 这种技术提供了有效的疼痛管理,为患者提供了最小的术后不适.
科学领域:
- 区域麻醉地区麻醉
- 疼痛管理 疼痛管理
- 电力生理学 电力生理学
背景情况:
- 胸部神经 (PECs) 阻塞是用于前胸壁止痛的既定区域麻醉技术.
- 传统上由麻醉科医生进行手术前.
- 在心脏植入式电子设备 (CIED) 程序期间,电生理学家执行PECs阻断的可行性尚未确定.
研究的目的:
- 评估由电生理学家执行的常规PECs块的可行性.
- 为了评估在植入过程中从暴露的CIED口袋中执行的技术.
主要方法:
- 在接受CIED手术的患者中进行了超声导向PECs I或PECs II阻断.
- PECs I 阻断了乳房大肌肉和小肌肉之间的注射.
- PECs II 块包括额外的注射,注射在小胸肌和前胸肌之间.
主要成果:
- 20名患者 (65±16岁,70%男性) 接受了这种手术.
- 术后平均疼痛评分较低 (4小时内0.4±0.8,24小时内0.3±0.6).
- 在手术后的前24小时内,只有4名患者需要服用阿片类药物.
结论:
- 在CIED手术过程中,当从暴露口袋内执行时,在手术期间的PECs阻断是可行的.
- 这种方法导致手术后疼痛最小.
- 电生理学家执行的PECs块为手术内止痛提供了一个可行的选择.
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