勃起器脊柱平面阻塞对术后静脉注射吗啡消耗在开放的肋下切除术中的影响:一个潜在的随机临床试验
Erkan Atıcı1, Zehra İpek Arslan1, Hasan Yılmaz2
1Department of Anesthesiology and Reanimation, Kocaeli University Faculty of Medicine, Kocaeli, Türkiye.
概括
勃起器脊柱平面阻塞 (ESPB) 显著减少了手术后的吗啡使用和疼痛,在接受开放性肋下脏切除术的患者. 这种止痛方法改善了患者的满意度,并减少了恶心.
科学领域:
- 麻醉学 麻醉学
- 手术疼痛管理手术疼痛管理
- 区域麻醉技术 区域麻醉技术
背景情况:
- 开放性切除术可能会导致严重的术后疼痛.
- 有效的疼痛管理对于患者在切除术后的康复和满意度至关重要.
- 勃起器脊柱平面阻塞 (ESPB) 是一种区域麻醉技术,在疼痛管理方面表现有前途.
研究的目的:
- 评估勃起器脊柱平面块 (ESPB) 在减少术后吗啡消耗方面的有效性.
- 评估ESPB对疼痛评分,止痛药要求和开放性肋下切除术后患者满意度的影响.
- 确定ESPB是否影响术后恶心的发生率.
主要方法:
- 一项随机对照研究包括46名接受选择性开放性肋下腎切除术的成年患者.
- 患者被分为两组:ESPB组 (接受0.25%布皮瓦卡因ESPB) 和对照组.
- 两组都接受了患者控制的静脉注射吗啡来缓解疼痛.
主要成果:
- 在ESPB小组中,手术内使用的雷米芬坦尼尔显著降低 (p<0.001).
- 在ESPB组中,术后的吗啡消耗显著减少 (16.8±4.13毫克 vs 33.65±6.91毫克,p<0.001).
- 在ESPB组报告较低的疼痛分数 (p<0.001),减少了额外的止痛药需求 (35%对95%,p<0.001),更高的患者满意度 (p=0.009),和更少的恶心 (p=0.007).
结论:
- 预防性勃起器脊柱平面阻塞是一种安全有效的止痛策略,用于开放的肋下脏切除术.
- ESPB显著降低了阿片类药物需求,并改善了患者报告的结果.
- 这种区域性麻醉技术在切术患者的术后疼痛管理中提供了实质性的好处.
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