连续流动局部麻醉剂伤口输液用于经过脏移植后的术后止痛
Parth U Thakker1, Davis M Temple2, Caroline Minnick2
1Department of Urology, Atrium Health Wake Forest Baptist, Winston-Salem, North Carolina, USA.
Clinical transplantation
|April 3, 2024
概括
连续流动局部麻醉伤口输液 (CFLAP) 与患者控制的止痛 (PCA) 相比,在移植患者中显著减少了93%的麻醉剂使用. 然而,CFLAP的使用与伤口并发症的轻微增加有关.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 移植手术 移植手术
- 疼痛管理 疼痛管理
背景情况:
- 药物依赖是末期病患者的一个担忧.
- 慢性麻醉剂使用对移植结果产生负面影响,增加了移植损失和死亡率.
- 有效的疼痛管理策略对于移植接受者至关重要.
研究的目的:
- 为了比较持续流动局部麻醉伤口输液 (CFLAP) 与患者控制的止痛 (PCA) 的疗效.
- 评估移植患者住院药物消耗的减少.
- 评估对术后结果和并发症的影响.
主要方法:
- 498名移植患者 (2020-2022) 的单中心,回顾性分析.
- 患者接受PCA (n=296) 与CFLAP (n=202) 进行术后疼痛控制的比较.
- 收集的数据包括人口统计,手术细节,结果,并发症和住院患者口服吗啡毫克相当 (OME) 消费.
主要成果:
- 与PCA组 (34 mg) 相比,CFLAP组 (2.5 mg) 的OME总需求明显低于PCA组 (34 mg) (p < .001).
- 与伤口相关的并发症在CFLAP组 (5.9%) 与PCA组 (2.7%) (p = .03) 中较高.
- 在CFLAP组中,有两名患者 (0.9%) 由于局部麻醉毒性而出现心律失常.
结论:
- 与PCA相比,CFLAP显示OME消费减少了93%.
- 通过CFLAP观察到与伤口有关的并发症的小幅增加.
- 局部麻醉可能对患有单侧腹部或骨盆切口的患者有益.
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