勃起器脊柱平面阻塞在冠状动脉外科手术中的疼痛缓解作用:一项随机对照试验
Akin Disikirik1,2, Murat Bilgi1,2, Mustafa Turkoglu1,2
1Department of Anaesthesiology and Reanimation, Abant Izzet Baysal University Medical School, Bolu, Turkiye.
Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
|February 11, 2024
概括
预防性勃起器脊柱平面 (ESP) 阻断在冠状动脉旁路移植 (CABG) 手术患者的术后疼痛和阿片类药物使用显著减少. 这种干预措施降低了疼痛评分和手术后对止痛药的需求.
科学领域:
- 麻醉学和疼痛管理
- 心血管外科心血管外科
背景情况:
- 冠状动脉旁路移植 (CABG) 手术与严重的急性术后疼痛有关.
- 有效的疼痛管理策略对于患者康复和CABG后的结果至关重要.
- 勃起器脊柱平面 (ESP) 块是一种区域麻醉技术,具有潜在的止痛效益.
研究的目的:
- 评估预防性勃起器脊柱平面 (ESP) 阻断在非抽动冠状动脉旁路移植 (CABG) 手术后治疗术后疼痛的疗效.
- 评估ESP阻断对阿片类药物消费 (手术内和术后) 和疼痛评分的影响.
主要方法:
- 一项随机对照试验,涉及50名接受CABG手术的患者 (ASA III风险).
- 患者被随机分配,在手术前 (E组) 或没有 (C组) 接受T5水平的双边ESP阻塞.
- 主要结局:术后的阿片类药物需求;次要结局:手术期间的阿片类药物需求,视觉模拟尺度 (VAS) 疼痛评分和住院时间.
主要成果:
- 组E在多个时间点 (0-1,1-12,12-24和0-48小时) 显示了术后特拉马多尔需求显著降低.
- 在E组 (p=0.001) 中,手术期间的芬太尼需求也显著减少 (p=0.001).
- 术后的VAS疼痛得分在E组明显低于C组在输出管后的各种间隔.
结论:
- 勃起器脊柱平面 (ESP) 块的预防性应用在降低CABG患者的术后阿片类药物需求方面是有效的.
- 在CABG手术后,ESP阻断显著缓解了急性术后疼痛.
- 这种区域麻醉技术提供了一种有希望的方法来增强疼痛控制,并可能改善心脏手术后的康复.
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