在腹腔镜胆囊切除术中对勃起器脊柱平面阻塞和椎阻塞进行了新的比较
Elvan Tekir Yılmaz1, Duygu Demiriz Gülmez2, Alparslan Apan1
1Giresun University, Faculty of Medicine, Department of Anesthesiology and Reanimation - Giresun, Turkey.
Revista da Associacao Medica Brasileira (1992)
|April 24, 2024
概括
与腹腔镜胆囊切除术中的直立脊柱平面阻断相比,准脊柱阻断提供了优异的术后疼痛缓解,并减少了特拉马多尔的消耗. 这两种阻断在疼痛管理方面都比没有阻断更有效.
科学领域:
- 麻醉学 麻醉学
- 手术疼痛管理手术疼痛管理
- 区域麻醉地区麻醉
背景情况:
- 勃起脊柱平面 (ESP) 阻断是一种较新的技术,潜在的并发症比准脊椎阻断 (PVB) 更少.
- 有效的术后止痛对于腹腔镜胆囊切除术后的康复至关重要.
- 优化疼痛管理策略可以改善患者的治疗结果,减少阿片类药物依赖.
研究的目的:
- 为了比较ESP阻断和PVB在经过腹腔镜胆囊切除术的患者的术后止痛的疗效.
- 为了确定这个手术群体的最安全和最有效的止痛程序.
- 评估这些阻断对疼痛评分和阿片类药物消费的影响.
主要方法:
- 一项随机对照试验,涉及90名患者 (美国麻醉学会I-II,年龄在18-70岁) 接受了腹腔镜胆囊切除术.
- 建立了三个组:控制组 (没有阻断,患者控制的用特拉马多尔镇痛),ESP阻断和PVB.
- 在术后24小时内使用视觉模拟量表 (VAS) 评估疼痛,并记录了特拉马多尔的总消耗量.
主要成果:
- 与控制组相比,PVB组的患者在休息和咳期间的VAS疼痛得分明显较低.
- 与控制组和ESP块组相比,PVB组的总特拉马多尔消费量显著降低.
- 虽然ESP阻断显示出特拉马多尔消费的某种减弱,但PVB显示出优越的整体止痛功效.
结论:
- 超声波导向的副脊椎阻断为腹腔镜胆囊切除术提供了有效的术后止痛.
- 勃起器脊柱平面阻塞可能有助于减少特拉马多尔的总消耗,但在这种情况下,PVB似乎更有效控制疼痛.
- PVB是一种推的区域麻醉技术,用于治疗腹腔镜胆囊切除术后的疼痛.
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