侧方四角腰部阻断与针治疗剖腹产后止痛:一个随机临床试验
Pei-Pei Qin1, Bing-Yu Zou1, Dan Liu1
1The Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
American journal of obstetrics & gynecology MFM
|July 17, 2024
概括
针和侧方四角腰部阻断 (L-QLB) 在剖腹产后显示出类似的疼痛控制. 与L-QLB相比,针改善了恢复指标,如调动时间和胃肠功能.
科学领域:
- 麻醉学 麻醉学
- 疼痛管理 疼痛管理
- 产科 产科 产科 产科 产科
背景情况:
- 剖腹产后的疼痛管理仍然是一个临床挑战.
- 侧方四角腰部阻断 (L-QLB) 和针都显示出治疗术后止痛的前景.
- 缺乏L-QLB和针之间的直接比较疗效数据.
研究的目的:
- 为了比较L-QLB的止痛效果与选择性剖腹产后的针.
- 评估手术后疼痛评分和剖腹产患者的康复参数.
主要方法:
- 一项前性随机受控试验,涉及190名在脊柱外皮麻醉下进行剖腹产的患者.
- 患者被随机分配,接受双边L-QLB或针 (通过皮肤进行电针点刺激和压针治疗).
- 所有参与者都获得了标准的术后疼痛管理,疼痛得分和恢复指标作为主要和次要结局.
主要成果:
- 在针和L-QLB组之间24小时运动后疼痛评分没有显著差异 (P=.40).
- 在手术后48小时内,患者控制的静脉静脉止痛 (PCIA) 消耗和疼痛得分相似.
- 与L-QLB相比,针在恢复质量-15 (QoR-15) 评分和加快胃肠道恢复 (第一次浮和饮酒) 中显著改善.
结论:
- 与L-QLB相比,针没有提供优异的术后疼痛缓解,也没有减少止痛药的消耗,作为剖腹产后多模式治疗方案的一部分.
- 与针组相比,L-QLB组显示动员时间显著延长.
- 针可以在剖腹产后的整体康复和胃肠功能方面提供好处.
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