勃起器脊柱平面阻断与四角腰部阻断用于腹腔镜切除术后的术后止痛:一个随机对照试验
Zhen Zhang1, Hao Kong1, Yan Li1
1Department of Anesthesiology, Peking University First Hospital, Beijing, China.
Journal of clinical anesthesia
|April 27, 2024
概括
勃起器脊柱平面阻塞在腹腔镜切除术后提供了优越的疼痛缓解,而不是四角腰部阻塞. 这种技术导致了较低的阿片类药物消费和减少患者的疼痛强度.
科学领域:
- 麻醉学 麻醉学
- 区域麻醉地区麻醉
- 手术疼痛管理手术疼痛管理
背景情况:
- 手术后的疼痛管理对于腹腔镜切除术后的患者康复至关重要.
- 区域麻醉技术,如勃起器脊柱平面 (ESP) 阻断和四角腰部 (QL) 阻断,越来越多地用于腹部手术.
研究的目的:
- 为了比较ESP阻断和QL阻断在腹腔镜切除术后的止痛效果.
主要方法:
- 一项随机对照试验,涉及110名接受腹腔镜切除术的患者.
- 患者接受了超声导向ESP阻断 (n=55) 或QL阻断 (n=55).
- 术后止痛包括患者控制的sufentanil,主要结局是24小时内累积的阿片类药物消耗.
主要成果:
- 在24小时内,ESP块组的累积sufentanil消费量显著降低 (中位数为13μg与25μg相比,P=0.041).
- 接受ESP阻断治疗的患者在所有测量时间点 (P≤0.009) 报告了较低的术后疼痛强度.
- 在ESP块组中观察到主观睡眠质量和恢复质量的改善 (分别P=0.018和P=0.012).
结论:
- 勃起器脊柱平面阻塞在腹腔镜脏切除术后提供优异的止痛效果,与四度腰部阻塞相比.
- 阻断ESP导致减少阿片类药物需求和疼痛强度,增强患者的恢复.
- 两块都是安全的,没有报告与程序相关的不良事件.
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