在经过腹腔镜胆囊切除术的患者中,勃起器脊柱和横向腹部平面块之间的止痛效应的比较
Hui Chen1, Junshi Li2, Jianfeng Zuo3
1Hui Chen, Department of Anesthesiology, Changxing County People's Hospital, Changxing Country, Huzhou 313100, Zhejiang Province, P.R. China.
Pakistan journal of medical sciences
|February 15, 2024
概括
勃起脊柱平面 (ESP) 块在腹腔镜胆囊切除术后提供优异的短期疼痛缓解,与横向腹部平面 (TAP) 块相比,需要更少的止痛. 两个块都显示了与不良事件相似的安全概况.
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:
- 腹腔镜胆囊切除术 (LC) 需要有效的术后疼痛管理.
- 勃起脊柱平面 (ESP) 阻断和横向腹部平面 (TAP) 阻断是用于腹部手术的区域麻醉技术.
- 对比ESP和TAP块的疗效和安全性对于优化患者康复至关重要.
研究的目的:
- 为了比较ESP阻断与TAP阻断在接受LC的患者中对ESP阻断的止痛作用.
- 评估和比较ESP和TAP块之间的术后不良事件的发生率.
主要方法:
- 对103名接受LC治疗的患者进行了回顾性观察研究.
- 根据阻断方法将患者分为ESP组 (n=56) 和TAP组 (n=57).
- 操作时间的比较,视觉模拟尺度 (VAS) 疼痛得分 (静态和动态),患者控制的止痛剂量 (PCA) 和24小时后的补救性止痛剂量.
主要成果:
- 动态VAS疼痛评分在ESP组在手术后1,3,6和12小时显著较低 (P<0.05).
- 在ESP组需要显著降低PCA和补救性止痛剂量 (P<0.05).
- 在手术后恶心和吐的发生率中,两组之间没有显著差异 (P>0.05).
结论:
- 与LC患者的TAP阻断相比,ESP阻断显示出优异的短期术后止痛.
- ESP和TAP块的操作时间和恶心和吐等不良事件的发生率都相似.
- 阻断ESP可能会导致LC后止痛药消耗减少.
相关概念视频
Local Anesthetics: Clinical Application as Spinal Anesthesia
629
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
629
Local Anesthetics: Clinical Application as Epidural Anesthesia
432
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
432
Local Anesthetics: Differential Sensitivity of Nerve Fibers
818
Local anesthetics (LAs) block the sodium channels of nerve trunks, sensory nerve endings, and neuromuscular junctions. Although LAs can block all kinds of nerves, the sensitivity of nerve fibers differs according to nerve types and structures. LAs are known to block myelinated fibers faster than unmyelinated ones. Also, they block pain or sensory neurons at low concentrations without affecting the motor neurons involved in muscle contractions. This helps relieve labor pain without affecting the...
818
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
413
Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
One of the advantages of...
413
Skeletal Muscle Relaxants: Therapeutic Uses
486
Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx...
486
Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia
1.1K
Depending on the target organ, local anesthetics (LAs) can be administered via various routes. In surface anesthesia, LAs are applied directly to the surface of the skin or mucous membranes. It is widely used for topical skin numbing before venipuncture or minor surgical procedures. Commonly used surface local anesthetics are lidocaine or benzocaine sprays or creams. Surface anesthesia occurs within 5 minutes and lasts for about 60 minutes. One of the main disadvantages of topical anesthesia is...
1.1K


