准脊椎和直立脊柱平面阻塞减少停留时间与本地透止痛相比,自主乳房重建的局部透止痛
Haripriya S Ayyala1, Melissa Assel2, Joseph Aloise3
1Division of Plastic and Reconstructive Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut, USA.
Regional anesthesia and pain medicine
|February 9, 2024
概括
用准脊椎 (PVB) 或直立脊柱平面 (ESP) 块取代局部透,可显著减少乳房重建患者的术后停留时间. 两块都提供了可比的好处,ESP成为PVB的可行替代品.
科学领域:
- 麻醉学 麻醉学
- 整形外科 整形外科 整形外科
- 在瘤学瘤学.
背景情况:
- 自主乳房重建通常涉及严重的疼痛,延迟了患者的康复.
- 目前的疼痛管理依赖于外科医生进行的局部透.
- 新的区域麻醉技术可能会改善结果.
研究的目的:
- 评估手术前准脊椎 (PVB) 和直立脊柱平面 (ESP) 阻塞作为局部透的替代方案的影响.
- 为了评估这些阻塞对疼痛管理和经过乳房骨肌皮片乳房重建后的恢复的影响.
主要方法:
- 对122名经过乳腺切除术的患者进行了回顾性队列研究,该患者的乳腺切除术与乳腺重建 (2018-2022年).
- 患者被分为三个组:局部透,PVB阻断和ESP阻断.
- 分析的重点是术后停留时间 (LOS),疼痛,阿片类药物消耗和抗药使用.
主要成果:
- 阻断PVB与术后LOS缩短了20小时 (p<0.001).
- 阻断ESP与24小时更短的术后LOS相关 (p<0.001).
- 阻断PVB和ESP都显著降低了手术期间的阿片类药物消费 (p<0.001).
结论:
- 用PVB或ESP块取代局部透,有效地减少了自主乳房重建的停留时间.
- ESP块为PVB提供了一种可行的替代方案,用于拉提西姆片乳房重建.
- 需要进一步的研究来比较ESP和PVB在复杂乳房重建中的患者结果.
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