肋间导管减少了VATS后的长期疼痛和术后阿片类药物消费
Marie-Christin Neuschmid1, Florian Ponholzer1, Caecilia Ng1
1Department of Visceral, Transplant and Thoracic Surgery, Center of Operative Medicine, Medical University of Innsbruck, 6020 Innsbruck, Austria.
Journal of clinical medicine
|May 25, 2024
概括
与神经阻塞相结合的肋间导管显著减少了视频辅助胸腔镜手术 (VATS) 后的阿片类药物使用和慢性疼痛. 这种方法可以改善VATS患者的康复和长期结果.
科学领域:
- 胸部外科手术 胸部外科手术
- 疼痛管理 疼痛管理
- 在瘤学瘤学.
背景情况:
- 视频辅助胸腔镜手术 (VATS) 后的术后疼痛可能会阻碍恢复并导致慢性疼痛.
- 目前对VATS患者的术后疼痛管理的指导方针是不够的.
- 使用阿片类药物来缓解疼痛可能会产生潜在的副作用和风险.
研究的目的:
- 为了评估结合单次内科手术间隔骨神经阻塞 (SSINB) 的肋间导管 (ICC) 的有效性.
- 将这种联合方法与单独的SSINB进行比较,以减少阿片类药物消费和慢性手术后疼痛 (CPSP).
- 在接受VATS的初级肺癌患者中分析疼痛管理策略.
主要方法:
- 在2019年至2022年期间,对141名接受了为原发性肺癌进行解剖VATS切除的患者进行了回顾性分析.
- 患者被分为两组:接受ICC和SSINB的患者和仅接受SSINB的患者.
- 排除标准包括没有足够的文档,外部随访和固定的阿片类药物表.
主要成果:
- 肋间导管组在范围,持续时间和频率方面显著减少了阿片类药物消费.
- 在前九个月内没有观察到疼痛率的显著差异,尽管趋势有利于ICC组.
- 手术后一年,骨干间导管组报告的慢性手术后疼痛率显著降低 (1.5%与10.8%相比).
结论:
- 插入肋间导管可显著改善VATS患者手术后疼痛的缓解.
- 使用ICC导致阿片类药物使用频率,持续时间和总消耗减少.
- 在VATS的一年后,ICC干预与慢性手术后疼痛的比率相对较低.
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