视频辅助胸腔镜手术后疼痛控制的胸腔镜间肋骨神经阻塞与尾酒止痛剂:一项前性队列研究
Jue Li1,2,3, Yingxian Dong1,2,3, Jiawei Guo4
1Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.
Journal of pain research
|March 25, 2024
概括
胸腔间肋间神经阻塞 (TINB) 在胸腔镜手术后提供优越的疼痛缓解,与患者控制的止痛疗法 (PCIA) 相比. 此外,TINB还显著减少了不良事件,改善了患者退院后的康复.
科学领域:
- 胸部外科手术 胸部外科手术
- 疼痛管理 疼痛管理
- 麻醉学 麻醉学
背景情况:
- 视频辅助胸腔镜手术 (VATS) 需要有效的术后疼痛管理.
- 患者控制的止痛疗法 (PCIA) 是一种常见的方法,但可能有局限性.
- 胸间肋间神经阻塞 (TINB) 是一种替代的止痛方法.
研究的目的:
- 为了比较尾酒胸间肋间神经阻塞 (TINB) 与患者控制的止痛疗法 (PCIA) 在VATS后的临床结果.
- 在接受VATS的患者中评估疼痛评分和止痛药相关不良事件 (ARAEs).
主要方法:
- 一系列连续的230名为肺结节进行VATS的患者被分为TINB和PCIA组.
- 休息 (RVAS) 和活跃 (AVAS) 疼痛的视觉模拟尺度 (VAS) 评分是主要结局.
- 与止痛药相关的不良事件 (ARAEs) 被记录并在各组之间进行比较.
主要成果:
- 虽然住院VAS得分没有显著差异,但TINB组的头,恶心,吐,疲劳和失眠率较低.
- 释放后的VAS分数 (7,14和30天) 在TINB组相比PCIA组显著较低.
- 在TINB组,与止痛药相关的不良事件较少.
结论:
- 尾酒TINB在VATS后提供优质的术后止痛,特别是在长期的退院后.
- 与PCIA相比,TINB与不良事件的发生率降低有关.
- 对于接受胸腔镜手术的患者来说,TINB 是一种更有效的止痛策略.
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