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不同区域止痛方法在胸部手术后对慢性疼痛的影响

Korgün Ökmen¹, Şule Balk¹, Gamze Gözen Güvenç²

¹Department of Anesthesiology and Reanimation, University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey.

Kardiochirurgia i torakochirurgia polska = Polish journal of cardio-thoracic surgery

|January 29, 2024

概括

区域麻醉技术,如状前平面 (SAP) 阻断和状肋间阻断 (RIB),有效地减少胸部手术后的慢性术后疼痛 (CPSP) 和神经病痛. 这些方法比患者控制麻醉 (PCA) 提供更好的结果.

科学领域:

麻醉学和疼痛管理
胸部外科手术胸部外科手术
区域麻醉技术区域麻醉技术

背景情况:

慢性术后疼痛 (CPSP) 在手术后3个月以上显著影响患者的生活质量.
有效的疼痛管理策略对于减轻与胸部手术相关的长期发病率至关重要.

研究的目的:

为了比较各种区域性镇痛方法在预防慢性胸部手术后疼痛方面的疗效.
为了评估胸部外周 (TE),状前平面 (SAP) 阻塞,状肋间阻塞 (RIB) 和准脊椎阻塞 (PVB) 对疼痛结果的影响.

主要方法:

总共分析了489名接受胸切除术或VATS的患者.
主要结局:视觉模拟尺度 (VAS) 在术后6个月的得分.
二次结局:神经病痛评估 (LANSS评分),止痛药的使用.

主要成果:

对于胸切除术,与TE和患者控制麻醉 (PCA) 相比,RIB和SAP块显示出明显较低的VAS得分.
对于VATS,RIB,SAP块和PVB,VAS得分明显低于PCA.
与PCA相比,神经病痛评分 (LANSS) 在胸切除术和VATS患者的RIB和SAP阻断下降.

结论:

区域麻醉技术,特别是RIB和SAP阻断,在胸部手术后有效减少一般和神经病痛.
这些发现支持在PCA上使用特定的区域块,以改善胸切除术和VATS后的长期疼痛管理.

关键词:

慢性疼痛是一种慢性疼痛.胸切除术后的疼痛综合征区域麻醉地区麻醉胸部外科手术胸部外科手术

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