相关实验视频
Updated: Jun 28, 2025

05:10
Gasless Endoscopic Thyroidectomy via the Trans-Axillary Approach
Published on: September 15, 2023
954
胸膜平面阻塞和中介椎结质阻塞的止痛作用,用于交叉侧内镜甲状腺切除术:一项前性随机对照试验
Dong Yin1, Zongsheng Duan1, Peisong Wang2
1Department of Anesthesiology, The First Hospital of Jilin University, Changchun, China.
Minerva anestesiologica
|April 23, 2024
概括
超声导向的乳腺平面阻断 (PSPB) 和中间椎阻断 (ICPB) 显著降低了经过过关节内镜甲状腺切除术 (TAET) 后的疼痛. 这种神经阻断技术改善了患者的满意度,而不会增加不良影响.
科学领域:
- 麻醉学 麻醉学
- 手术瘤学手术瘤学
- 区域麻醉地区麻醉
背景情况:
- 穿式内镜甲状腺切除术 (TAET) 提供了美容和功能上的好处.
- 传统上,TAET的术后疼痛管理依赖于全身止痛药.
- 区域麻醉在TAET中为疼痛控制提供了一个潜在的替代方案.
研究的目的:
- 评估结合超声导向胸部平面阻断 (PSPB) 和中间宫阻断 (ICPB) 在TAET后术后止痛的疗效.
- 为了比较接受神经阻塞和对照组的患者之间的疼痛评分和患者满意度.
主要方法:
- 接受TAET的40名患者被随机分配到神经阻塞组 (PSPB + ICPB) 和对照组.
- 神经阻断组通过超声波引导的PSPB和ICPB接受了罗皮瓦卡因.
- 在多个时间点使用视觉模拟量表 (VAS) 评估术后疼痛;次要结果包括止痛药的需求和患者满意度.
主要成果:
- 神经阻塞组在TAET后24小时内,在休息和运动期间的部和下部疼痛方面显示出明显较低的VAS得分.
- 与对照组相比,神经阻塞组的患者满意度显著更高.
- 两组之间在手术内摄入雷米芬坦尼尔,需要救援止痛药或不良事件方面没有发现显著差异.
结论:
- 结合超声波引导PSPB和ICPB有效缓解TAET后的术后疼痛.
- 这种区域麻醉技术提高了TAET后的患者满意度.
- PSPB和ICPB的组合是TAET的安全有效的止痛策略.
相关概念视频
Depolarizing Blockers: Mechanism of Action
1.5K
Depolarizing blockers act on skeletal muscle fibers' membranes and induce their depolarization. Most depolarizing blockers have two quaternary N+ atoms that bind the nicotinic acetylcholine receptors and cause neuromuscular blockade within minutes.
Succinylcholine is the most commonly used depolarizing blocker. Chemically, it constitutes two molecules of acetylcholine joined together by an acetate methyl group. They act on the receptors in the same way as acetylcholine. Because...
Succinylcholine is the most commonly used depolarizing blocker. Chemically, it constitutes two molecules of acetylcholine joined together by an acetate methyl group. They act on the receptors in the same way as acetylcholine. Because...
1.5K
Nondepolarizing (Competitive) Neuromuscular Blockers: Pharmacological Actions
416
Nondepolarizing neuromuscular blockers prevent the membrane depolarization of muscle cells and inhibit muscle contraction. These are usually administered with anesthetics to achieve complete muscle relaxation. Upon administration, these drugs first block the small, rapidly contracting muscles of the face and hands, followed by the larger muscles of the trunk and the intercostal muscles. The diaphragm is the last muscle to be affected.
Although all competitive neuromuscular blockers are designed...
Although all competitive neuromuscular blockers are designed...
416
Depolarizing Blockers: Pharmocokinetics
323
Depolarizing blockers are administered through intravenous injection. Succinylcholine is the most common choice of depolarizing blockers in emergency clinical practices. Although they have a rapid onset, they readily diffuse away from the motor end plate into the extracellular fluid. They are metabolized by enzymes such as liver butyrylcholinesterase and plasma pseudocholinesterases. This produces a short duration of action, typically 5-10 minutes long, unlike nondepolarizing blockers, which...
323
Skeletal Muscle Relaxants: Adverse Effects
361
Skeletal muscle relaxants are widely used for muscle paralysis and relieving pain following any muscle injury or stiffness. However, depending on the drug type, they can have adverse effects that range from mild to severe. Usually, nondepolarizing neuromuscular blockers have minimal side effects. For example, drugs like d-tubocurarine, cisatracurium, and rocuronium cause hypotension, whereas drugs like baclofen, when stopped abruptly, can lead to the recurrence of spastic conditions.
Unlike...
Unlike...
361
Skeletal Muscle Relaxants: Therapeutic Uses
482
Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx...
482
Local Anesthetics: Clinical Application as Spinal Anesthesia
620
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
620

