添加周围块可以增强血切除术后的疼痛控制吗? 一项前性随机,双盲,安慰剂控制的研究
Daniil Markaryan1, Tatiana Garmanova1, Ekaterina Kazachenko1
1Surgical Department, Medical Research Educational Centre, Lomonosov Moscow State University, Moscow, Russian Federation.
ANZ journal of surgery
|July 29, 2024
概括
术内围阻断显著降低了手术后疼痛和阿片类药物使用在接受带切除术的患者. 这种安全有效的技术改善了患者的康复,无痛期,以及直肠手术后的整体满意度.
科学领域:
- 麻醉学 麻醉学
- 结肠直肠手术 结肠直肠手术
- 疼痛管理 疼痛管理
背景情况:
- 切除术通常会导致严重的术后疼痛,延长康复时间,并降低生活质量.
- 大多数患者在手术后会经历中度至严重的疼痛.
- 在治疗这种疼痛方面,手术内围阻塞的有效性正在研究中.
研究的目的:
- 评估手术内围阻塞在接受切除术的患者中的作用和疗效.
- 评估阻断对术后疼痛,阿片类药物消耗和患者康复的影响.
主要方法:
- 一项前性,随机,双盲,安慰剂控制的研究,涉及患有III-IV期的患者.
- 患者接受了带脊髓麻醉的手术内围阻塞 (实验组) 或单独的脊髓麻醉 (对照组).
- 主要终点是术后阿片类药物消费;次要终点包括疼痛水平 (VAS),止痛药使用,恢复工作,生活质量 (SF-36),以及患者满意度.
主要成果:
- 实验组报告术后疼痛明显减少 (P < 0.0001),并且需要较少的阿片类止痛药 (P = 0.03).
- 接受围阻塞的患者经历了更长的无痛期 (P = 0.0002) 并需要更少的额外NSAID注射 (58%对90%).
- 在实验组中,生活质量 (SF-36) 和患者满意度显著提高 (分别P < 0.001和P = 0.012).
结论:
- 术内围阻塞是接受切除术的患者的安全有效补充.
- 该程序导致疼痛管理,恢复和患者满意度的显著改善.
- 建议适合接受直肠外科手术的患者使用,以改善术后的结果.
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