在冠状动脉旁路移植与胸骨切除术中,预防性深部巴斯特纳间肋平面阻断用于外科手术期间止痛:一种随机,盲目观察者,受控研究
1Department of Anesthesiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
Annals of medicine
|February 20, 2024
概括
深部副间肋间平面 (DPIP) 阻断有效地减少了在心脏手术期间和之后的疼痛药物需求. 在T3-4和T4-5注射部位显示了这一关键的手术止痛药的类似结果.
科学领域:
- 麻醉学 麻醉学
- 胸部外科手术 胸部外科手术
- 疼痛管理 疼痛管理
背景情况:
- 深侧侧侧骨间角平面阻塞 (DPIP) 是心脏手术中的一种潜在的止痛技术.
- 它的精确特征和有效性需要进一步阐明.
研究的目的:
- 通过胸骨切除术确定预防性DPIP阻断冠状动脉绕道移植 (CABG) 的疗效.
- 为了定义皮肤感觉阻断面积和DPIP阻断的持续时间.
- 为了比较DPIP阻断T3-4与T4-5肋间间空间的疗效.
主要方法:
- 一个前性,单盲,随机对照试验,涉及90名接受选择性CABG的患者.
- 患者被分为三个组:T3-4 DPIP 块,T4-5 DPIP 块和对照组.
- 关键的结果措施包括手术内和手术后止痛药的要求,疼痛得分,输出管的时间和不良事件.
主要成果:
- 与对照组相比,预防性DPIP阻断显著降低了手术内sufentanil的需求 (p < 0.001).
- DPIP阻断降低了术后止痛药消耗和疼痛评分 (p < 0.01).
- 阻塞提供了足够的麻醉覆盖,减少了输出时间,并降低了恶心发生率,在T3-4和T4-5位点之间具有可比的疗效. 超过24小时的止痛是不够的.
结论:
- 预防性双边DPIP阻断在心脏手术期间和心脏手术后立即提供有效的止痛.
- 在T3-4和T4-5肋间空间的止痛作用是可比的.
- 阻断DPIP是治疗CABG患者疼痛的宝贵工具.
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