在心脏外科手术患者进行椎切除术时,用于手术内疼痛控制的深度副侧间肋间平面块:一项前性随机对照试验
Henry M K Wong1, P Y Chen1, Geoffrey C C Tang1
1Department of Anesthesia and Intensive Care, Prince of Wales Hospital, New Territories, Hong Kong, China.
Journal of cardiothoracic and vascular anesthesia
|December 26, 2023
概括
双边深部副侧侧侧肋间平面 (DPIP) 阻塞显著减少了手术内阿片类药物的使用,并改善了心脏手术患者的血液动力稳定性. 这种新的技术提供了有效的止痛药,可以促进恢复.
科学领域:
- 麻醉学 麻醉学
- 疼痛管理 疼痛管理
- 胸部外科手术 胸部外科手术
背景情况:
- 脊椎切除术疼痛是心脏手术后的一个重大挑战.
- 深部副间肋间平面 (DPIP) 阻断是前胸壁止痛的新兴技术.
研究的目的:
- 评估双边DPIP阻断在心脏手术期间控制手术内疼痛的疗效.
- 评估DPIP阻断对阿片类药物消费和血液动力学参数的影响.
主要方法:
- 一个双盲,前性随机受控试验,涉及86名选择性心脏手术患者.
- 患者接受了双边DPIP阻断与levobupivacaine或控制 (盐水) 在超声指导下.
- 术内阿片类药物消费和血液动力学变化是主要结局.
主要成果:
- DPIP组显示,手术期间的阿片类药物需求显著减少 (中位数为9.5mg与21.4mg吗啡相当).
- 血液动力学参数,包括血压,在胸切割过程中在DPIP组中更稳定.
- 在术后的结局 (如疼痛评分或输出时间) 中没有发现显著差异.
结论:
- 双边DPIP阻塞提供有效的手术内止痛,并减少心脏外科手术中的阿片类药物需求.
- 这种技术可以成为多式联络止痛策略的宝贵组成部分,以加强胸腔切除术后的恢复.
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