泌尿器科视频,镜或机器人手术的止痛策略,以改善手术后的康复方案:一项前性研究,比较勃起器脊柱平面块与横向腹部平面块
Marco Micali1, Giada Cucciolini2, Giulia Bertoni3
1Anaesthesia and Intensive Care Unit, E.O. Ospedali Galliera, 16128 Genoa, Italy.
Journal of clinical medicine
|January 23, 2024
概括
在泌尿外科手术后,超声导向的勃起器脊柱平面阻塞 (ESPB) 与横向腹部平面阻塞 (TAPB) 相比,提供更好的术后疼痛缓解. 通过使用较少局部麻醉剂,ESPB降低了疼痛评分和止痛救援需求.
科学领域:
- 麻醉学 麻醉学
- 区域麻醉地区麻醉
- 疼痛管理 疼痛管理
背景情况:
- 带平面块已经为术后疼痛提供了先进的区域麻醉.
- 将超声导向勃起器脊柱平面块 (ESPB) 和横腹部平面块 (TAPB) 进行比较,对于优化泌尿外科手术中的止痛至关重要.
研究的目的:
- 为了比较超声导向双边ESPB与双边TAPB在术后疼痛管理中的疗效.
- 为了评估疼痛评分,止痛救援要求,以及泌尿外科手术患者的这些阻塞后的不良事件.
主要方法:
- 一项前性观察性研究,涉及ESPB组的97名患者和TAPB组的93名患者.
- 在ESPB组接受了双边超声导向ESPB与罗皮瓦卡因和德克斯美德托米丁.
- TAPB组接受了双边超声导向的TAPB与罗皮瓦卡因.
主要成果:
- 在0-3天,ESPB组的术后数值评分尺度 (NRS) 疼痛分数显著降低 (p < 0.001).
- 在ESPB组中,较少的患者需要补充止痛救援疗法 (p < 0.001).
- 与TAPB相比,ESPB需要更少的局部麻醉,并导致术后恶心和吐的发生率较低.
结论:
- 超声导向双边ESPB在泌尿外科手术中提供有效的术后疼痛控制.
- ESPB至少与TAPB加吗啡一样有效,局部麻醉剂消耗减少.
- ESPB是术后止痛的安全有效替代品,最大限度地减少了急救药物的需要.
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