术前和术后的超声波导向直肠围膜阻塞用于腹腔镜术后急性术后疼痛缓解:一项回顾性队列研究
Mayuko Nakazawa1,2, Toko Fukushima1,2, Kazuhiro Shoji1,2
1Department of Anesthesiology, Tokyo Jikei University Katsushika Medical Center, Tokyo, Japan.
Medicine
|March 29, 2024
概括
在腹腔镜手术前执行直肠围阻断 (RSB) 可能会改善疼痛管理. 在手术前的RSB与手术后的RSB相比,在手术后24小时内需要止痛药的风险较低.
科学领域:
- 麻醉学 麻醉学
- 手术疼痛管理手术疼痛管理
背景情况:
- 直肠膜阻塞 (RSB) 通常用于腹腔镜手术期间的疼痛控制.
- 施用RSB的最佳时间 (手术前和术后) 仍然不确定.
研究的目的:
- 为了研究在进行腹腔镜手术的患者中直肠封锁 (RSB) 的理想时间.
- 为了比较在手术前和手术后RSB之间24小时内需要救援止痛的需要.
主要方法:
- 从2013年至2018年,对609名接受了RSB腹腔镜手术的患者进行了回顾性队列研究.
- 使用多变量考克斯回归分析,包括倾向得分 (PS) 匹配,分析第一个止痛要求的时间.
- 术前 (RSB前) 和术后 (RSB后) 组之间的比较.
主要成果:
- 在PS匹配后 (每组97名患者),第一个止痛要求的时间没有显著差异 (322分钟与294分钟相比).
- 然而,RSB前组显示,需要在24小时内进行首次止痛药的风险明显较低 (调整后的危险比:0.71;P=0.023).
结论:
- 在腹腔镜手术中,可能更喜欢进行手术前的直肠围膜阻塞 (RSB).
- 手术前的RSB与在手术后的最初24小时内减少了救援止痛的需求有关.
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