在低分泌神经刺激中对疼痛结果的比较分析:避免消化腺
Bethany Ho1, Brandon K Nguyen2, Senja Tomovic2
1Hackensack Meridian School of Medicine, Nutley, NJ, USA; Department of Otolaryngology - Head and Neck Surgery, Hackensack Meridian Health, Hackensack, NJ, USA.
American journal of otolaryngology
|July 25, 2024
概括
在低分泌神经刺激 (HNS) 手术期间避免消化肌收缩,可显著减少阻塞性睡眠呼吸暂停患者手术后的脑下疼痛. 这种修改后的植入技术可以改善患者在HNS手术后的治疗结果和舒适度.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 神经外科 神经外科
- 睡眠医学 睡眠医学
背景情况:
- 上呼吸道刺激 (UAS) 为阻塞性睡眠呼吸暂停 (OSA) 提供了有效的治疗方法,特别是对于持续正气道压力 (CPAP) 坚持不佳的患者.
- 传统的低分泌神经刺激器 (HNS) 植入包括消化腺肌收缩以获得神经接入,这是一种与术后脑下疼痛相关的过程.
- 尽量减少外科手术的侵入性对于改善患者体验和康复至关重要.
研究的目的:
- 为了比较手术后疼痛结果,在接受HNS植入,消化收缩和没有消化收缩的患者之间.
- 评估用于HNS位的替代外科技术的安全性和有效性.
- 评估手术内技术修改对患者舒适度和术后结果的影响.
主要方法:
- 在2017年至2021年期间接受HNS植入物的108名患者进行了回顾性图表审查.
- 分析了患者数据,包括人口统计,并发症和术后症状.
- 涉及消化收缩与不收缩的手术技术使用基平方和独立t测试进行了比较.
主要成果:
- 与那些经历了收缩 (18.37%) (p < 0.01) 的患者相比,在避免消化收缩的患者 (1.69%) 中观察到术后脑下疼痛显著减少 (p < 0.01).
- 在植入和定位后,总体患者满意度报告为高.
- 经过修改的技术证明了有利的安全概况.
结论:
- 在HNS植入过程中省略消化收缩是减少术后疼痛和不适的安全有效方法.
- 这种替代性手术方法可以提高HNS植入患者的外科治疗结果.
- 这些发现支持在临床实践中采用这种不那么侵入性的技术.
相关概念视频
Hormonal Regulation
Hormones regulate a significant portion of digestion through activation of the neuroendocrine system. The neuroendocrine system of digestion contains many different hormones all with multiple functions that are both, directly and indirectly, involved in digestion.
Peripherally and Centrally Acting Muscle Relaxants: A Comparison
Skeletal muscle relaxants can target the central nervous system [CNS] to reduce muscle tension or act directly at the neuromuscular junction to induce temporary paralysis. These two classes of muscle relaxants are called centrally acting muscle relaxants and peripherally acting muscle relaxants. They differ in their action, mechanism, administration route, and clinical uses.
Centrally acting muscle relaxants can be further divided into spasmolytic and antispasmodic drugs. Spasmolytic drugs,...
Centrally acting muscle relaxants can be further divided into spasmolytic and antispasmodic drugs. Spasmolytic drugs,...
Local Anesthetics: Differential Sensitivity of Nerve Fibers
Local anesthetics (LAs) block the sodium channels of nerve trunks, sensory nerve endings, and neuromuscular junctions. Although LAs can block all kinds of nerves, the sensitivity of nerve fibers differs according to nerve types and structures. LAs are known to block myelinated fibers faster than unmyelinated ones. Also, they block pain or sensory neurons at low concentrations without affecting the motor neurons involved in muscle contractions. This helps relieve labor pain without affecting the...
Analgesia and Pain Management
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
Pain
Pain serves as a critical warning signal that alerts the body to potential or actual harm. When mechanical pressure on the skin is intense, such as from a sharp pinch, the sensation transitions from touch to pain. Similarly, extreme temperatures, like a hot pot handle, convert the sensation of heat into pain. Pain can also result from overstimulation of other senses, such as blinding light, loud noise, or the intense heat from habañero peppers. This ability to sense pain is essential for...
Esophageal Achalasia
Esophageal achalasia is a chronic neurogenic disorder characterized by impaired relaxation of the lower esophageal sphincter (LES) and absent or ineffective peristalsis in the distal esophagus. This leads to a functional obstruction without a physical blockage, despite significant disruption of esophageal motility.EtiologyAchalasia is caused by degeneration of the myenteric (Auerbach's) plexus, specifically the loss of inhibitory ganglion cells that produce vasoactive intestinal peptide (VIP)...


