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在儿科腺切除术中,超囊性大神经阻断和阿片类药物要求:一项随机临床试验
Carole Lin1, Steven Abboud1, Veronica Zoghbi1
1Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, California.
JAMA otolaryngology-- head & neck surgery
|May 23, 2024
概括
脑上上神经 (SZMN) 阻断在接受腺切除术的儿童中显著减少疼痛和阿片类药物使用. 这种技术提供了一种安全有效的方法来管理小儿术后疼痛,并发症较少.
科学领域:
- 麻醉学 麻醉学
- 儿科手术 儿科手术
- 疼痛管理 疼痛管理
背景情况:
- 儿科腺切除术疼痛通常用阿片类药物来治疗,增加并发症风险.
- 有效的疼痛控制对于在腺切除术后的儿科康复至关重要.
研究的目的:
- 评估上关节神经 (SZMN) 阻塞在减轻疼痛和小儿腺切除术后阿片类药物消费方面的疗效.
- 评估与SZMN块相关的恢复持续时间和并发症率.
主要方法:
- 一项随机,盲目的前性研究,涉及53名儿科患者 (2-14岁) 接受内腺切除术.
- 患者被随机分配,接受双边SZMN阻塞或作为对照.
- 主要结局包括阿片类药物消费,FLACC评分和无阿片类药物PACU停留.
主要成果:
- 在SZMN阻断组显示显著降低阿片类药物消费 (0.07毫克/千克对比0.15毫克/千克) 和FLACC得分 (0.7对比1.6).
- 阻断组中较高比例的患者实现了无阿片类药物后麻醉护理单位 (PACU) 停留 (58%对26%).
- 两组之间没有观察到副作用或神经阻塞相关并发症的显著差异.
结论:
- 在儿科腺切除术中,SZMN阻塞是治疗术后疼痛的有效补充.
- 这种技术导致阿片类药物使用的临床上有意义的减少,并保持低并发症概况.
- SZMN 块是改善儿科手术患者疼痛管理结果的宝贵工具.
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