在关节镜肩部手术中使用副副神经上干块对隔膜节约的疗效:一项随机对照试验
Yumin Jo1, Chahyun Oh, Woo-Yong Lee
1From the Department of Anaesthesiology and Pain Medicine (YJ, CO, DL, SS, WC, CL, SYL, BH) and Department of Orthopaedic Surgery, Chungnam National University Hospital, College of Medicine, Chungnam National University, Daejeon, South Korea (W-YL).
European journal of anaesthesiology
|July 4, 2024
概括
在肩膀手术后,上干块 (UTB) 显著降低了与间干块 (ISB) 相比,半半膜膜 (HDP) 的风险. 这两种技术都提供了可比的术后疼痛缓解.
科学领域:
- 麻醉学 麻醉学
- 区域麻醉地区麻醉
- 胸部外科手术 胸部外科手术
背景情况:
- 跨层阻塞 (ISB) 经常用于肩部手术止痛,但具有高危的半膜膜 (HDP) 的风险.
- 上部干块 (UTB) 已被提出作为减轻HDP风险的替代方案.
- 这项研究旨在比较UTB和ISB之间HDP的发病率和镇痛功效.
研究的目的:
- 为了评估上干块 (UTB) 是否会导致半腹膜 (HDP) 的发病率较低,而不是间干块 (ISB).
- 评估UTB与ISB在关节镜肩部手术后的止痛效果.
- 为了比较两个阻断技术之间的术后肺功能,疼痛评分和阿片类药物消耗.
主要方法:
- 进行了一项随机对照试验,70名患者接受了关节镜旋转手套修复.
- 患者接受了超声导向ISB或UTB,使用0.75%的罗皮瓦卡因.
- 主要结果是半隔膜,通过超声波测量隔膜外进行评估. 二次结局包括肺功能,疼痛评分和阿片类药物使用.
主要成果:
- 完全HDP的发生率在UTB组 (5.9%) 与ISB组 (41.7%) 相比显著较低 (P < 0.001).
- 在阻塞后的ISB组中观察到肺功能下降更明显.
- 在UTB和ISB组之间,在1小时后的术后疼痛得分或其他次要结果中没有发现显著差异.
结论:
- 上部干部块 (UTB) 与半腹膜 (HDP) 的发病率相比,与间块 (ISB) 的发病率相对较低.
- 在关节镜肩部手术中,UTB提供了有效的止痛药,与ISB相似.
- 在肩膀手术中,UTB是ISB的更安全的替代品,可以最大限度地减少腹膜功能障碍,同时确保足够的疼痛控制.
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