胸前副脊柱阻塞对皮肤后质缩的止痛作用:一项回顾性研究
Heitor Js Medeiros1, Erica Gee1, Aimee Pak2
1Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, USA.
Cureus
|June 14, 2024
概括
胸前副脊椎阻塞 (PVB) 在皮肤穿透性神经缩 (PCNL) 后没有显著降低疼痛评分. 然而,它确实减少了患者控制的止痛疗法 (PCA) 的使用,这表明在阿片类药物管理中存在潜在的益处.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 麻醉学 麻醉学
- 疼痛管理 疼痛管理
背景情况:
- 对于结石而言,皮肤穿透性结石 (PCNL) 通常会导致明显的手术后疼痛和增加阿片类药物的使用.
- 胸部副脊椎阻塞 (PVB) 是一种区域麻醉技术,可以缓解术后的疼痛.
研究的目的:
- 为了比较手术后的疼痛评分,在接受PCNL的患者和没有手术前单次PVB.
- 评估PVB对患者控制的止痛药 (PCA) 使用,阿片类药物的总消耗以及术后恶心和吐 (PONV) 的影响.
主要方法:
- 对341名接受PCNL的患者进行了回顾性队列研究.
- 在T7-9的胸部水平上使用PVB和20毫克克的布皮瓦卡因 (0.25%-0.5%).
- 接受PVB (RA组) 和未接受PVB (NB组) 患者之间的结局比较.
主要成果:
- 区域麻醉 (RA) 组显示PCA使用量有统计学意义的减少 (OR = 0.19,p = 0.008).
- 两组之间在阿片类药物总消费量,疼痛得分或PONV方面没有发现显著差异.
- 在RA和NB组之间,人口统计数据是可比的.
结论:
- 手术前PVB在PCNL后的整体疼痛管理中没有显著的优势.
- 使用PVB与减少PCA麻醉剂的利用有关.
- 需要使用受控的外科因素进行更大规模的研究,以确认PVB对PCNL后疼痛的疗效.
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