区域性止痛使用超声导向的中间椎阻与椎起器脊柱阻用于前椎手术:一项随机试验
Alshaimaa Abdel Fattah Kamel1,2, Ahmed M Fahmy3, Heba M Fathi4
1Anaesthesia, Intensive Care and Pain Management Department, Faculty of Human Medicine, Zagazig University, Alsharkia, Egypt. eaKamil@zu.edu.eg.
BMC anesthesiology
|April 22, 2024
概括
中间椎 (IC) 块没有提供优异的术后疼痛缓解,与椎起器脊柱 (ES) 块相比,用于前椎脊柱手术. 阻断ES导致较低的纳尔布芬消耗,表明潜在的更好的持续止痛.
科学领域:
- 麻醉学 麻醉学
- 区域麻醉地区麻醉
- 疼痛管理 疼痛管理
背景情况:
- 有效的区域性止痛疗法对于部脊椎手术后的疼痛管理至关重要.
- 麻醉科医生寻求宫区域的最佳和安全的区域技术.
- 这项研究比较了中间椎 (IC) 阻塞与椎直立脊柱 (ES) 阻塞,用于椎前脊椎手术.
研究的目的:
- 为了评估一个中间的椎 (IC) 块是否提供优异的术后止痛与椎起器脊柱 (ES) 块相比.
- 评估两种区域止痛技术在接受前椎手术的患者的疗效和安全性.
主要方法:
- 这是一项双盲前性试验,涉及58名患者,随机分配到IC或ES块组.
- 超声导向双边IC块 (15毫升布皮瓦卡因0.25%每侧) 与双边ES块 (15毫升布皮瓦卡因0.25%每侧) 在C6.
- 主要结局:到第一次救援止痛的时间 (纳尔布芬);次要结局:阻断性能/发病时间,疼痛评分 (VAS),阿片类药物消费和并发症.
主要成果:
- 在IC组显著缩短了阻断性能和感觉发作时间.
- 在IC组 (7.31 ± 1.34小时) 和ES组 (11.10 ± 1.82小时) 中,到第一次纳尔布芬止痛的时间较短.
- 与ES组 (22.76 ± 8.62 mg) 相比,IC组 (33.1 ± 10.13 mg) 的纳尔布芬总消耗量更高. 手术后的VAS得分与8小时和12小时的一些变化相似.
结论:
- 中间椎 (IC) 块与椎直立脊柱 (ES) 块相比,在椎脊柱前部手术中不提供优异的术后区域止痛.
- 虽然IC阻断显示出更快的发作,但ES阻断与更低的救援止痛消耗有关.
- 研究结果表明,ES阻断可能会提供更持久的疼痛缓解,或者在术后需要更少的补充止痛.
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