在直接视线下放置的脂质体布皮瓦卡因肋间阻塞可以减少胸部手术中吗啡的使用
Anupama Singh1, Miles McAllister1, Luis E De León1
1Department of Thoracic Surgery, Brigham and Women's Hospital, Boston, MA, USA.
Journal of thoracic disease
|March 20, 2024
概括
脂质体布皮瓦卡因 (LB) 提供了更好的疼痛控制和更少的并发症比胸部外周止痛疗法 (TEA) 在微创肺部手术后. 这种方法也导致患者住院时间缩短.
科学领域:
- 疼痛管理 疼痛管理
- 胸部外科手术 胸部外科手术
- 麻醉学 麻醉学
背景情况:
- 胸部外周止痛药 (TEA) 和脂质体布皮瓦卡因 (LB) 用于术后疼痛控制.
- 有限的数据比较了微创肺切除后的LB与TEA.
研究的目的:
- 在TEA和LB组之间比较术后疼痛,阿片类药物使用和结果.
- 评估LB作为TEA的替代方案,用于微创肺切除.
主要方法:
- 对391名接受微创肺切除术的患者进行了回顾性图表审查.
- 患者接受了手术期间的LB或TEA.
- 疼痛评分,阿片类药物使用 (MME) 和术后结果进行了比较.
主要成果:
- LB组手术后并发症较少 (18%vs. 34%),24小时和48小时疼痛得分较低.
- 在手术后48小时内,LB患者所需的麻醉剂较少.
- 在LB患者中,住院时间的中位数显著较短 (2vs4天).
结论:
- 腰椎间隔阻塞是胸部手术后疼痛管理中TEA的一个可行的替代方案.
- LB减少了吗啡的使用,术后并发症和住院时间.
- 与TEA相比,LB在微创肺切除中提供了更好的结果.
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