编程间歇性玻尿酸与基于导管的直立器脊柱平面阻塞的连续输液对胸腔镜手术中恢复质量的质量:单中心随机对照试验
Aisling Ni Eochagain1, Aneurin Moorthy2, John Shaker3
1Division of Anaesthesiology, Mater Misericordiae University Hospital, Dublin, Ireland; EuroPeriscope, ESAIC Onco-Anaesthesiology Research Group, Europe; School of Medicine, University College, Dublin, Ireland.
British journal of anaesthesia
|July 30, 2024
概括
编程间歇性玻尿酸 (PIB) 勃起器脊柱平面 (ESP) 阻断在视频辅助胸腔镜手术 (VATS) 后与持续输液 (CI) 相比,提供类似的恢复质量. PIB疗法可以减少VATS后的恶心和吐.
科学领域:
- 区域麻醉学 区域麻醉学
- 胸部外科手术 胸部外科手术
- 疼痛管理 疼痛管理
背景情况:
- 勃起器脊柱带平面 (ESP) 块是用于减少视频辅助胸腔镜手术 (VATS) 后术后疼痛的区域麻醉技术.
- 带平面阻塞通过在肌肉平面之间传播局部麻醉剂来起作用.
- 间歇性玻尿酸注射可能会提高这些阻塞的临床疗效.
研究的目的:
- 测试假设,为术后ESP阻断止痛提供局部麻醉剂的编程间歇性玻尿酸 (PIB) 输送在改善VATS后恢复质量的方面优于连续输注 (CI) 方案.
- 在增值税的背景下,比较GDP与CI制度对ESP区块的有效性.
主要方法:
- 一项前性,双盲,随机对照试验与60名接受VATS的患者进行.
- 参与者接受了ESP阻塞导管,并随机分配到CI或PIB局部麻醉疗法,用于术后疼痛管理.
- 主要结局是手术后24小时的恢复质量-15 (QoR-15) 评分,次要结局包括呼吸功能,阿片类药物使用,疼痛评分,动员时间,恶心/吐和住院.
主要成果:
- 在PIB和CI组之间24小时后的整体QOR-15得分没有显著差异 (115.5对110,P=0.29).
- PIB组显示恶心和吐的统计显著减少 (P=0.03) 和更低的救援抗药的需求 (14%对41%,P=0.04).
- 对于其他次要结果,两组之间没有发现显著差异.
结论:
- 在VATS给出24小时后可比 Continuous Infusion (CI) 疗程的恢复质量-15分数后,通过ESP块的编程间歇性玻尿酸 (PIB) 疗法提供的术后止痛疗法.
- PIB疗法在减轻增值税后的恶心和吐方面显示出潜在的益处.
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