在心脏植入式电子设备手术过程中进行手术期间的胸部神经堵塞
Timothy M Markman1, David Lin1, Saman Nazarian1
1Department of Medicine, Division of Cardiovascular Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
Heart rhythm
|August 26, 2024
概括
术内胸部神经阻塞 (PECs) 在心脏植入式电子设备 (CIED) 程序后显著降低了急性术后疼痛和阿片类药物使用. 这种技术很容易通过在手术过程中植入医生来执行.
科学领域:
- 电子生理学 电子生理学
- 疼痛管理 疼痛管理
- 区域麻醉地区麻醉
背景情况:
- 心脏植入式电子设备 (CIED) 程序与严重的术后疼痛有关.
- 用阿片类药物治疗疼痛有风险,包括持续使用.
- 胸部神经 (PECs) 阻塞对胸壁疼痛有希望,但在电生理学中未得到充分利用.
研究的目的:
- 在CIED手术过程中评估手术内超声波引导PECs阻断的有效性.
- 为了评估由植入医生从设备口袋执行的阻塞是否有益.
主要方法:
- 一项前性研究包括610名在7个中心 (2022-2023) 接受CIED手术的患者.
- 患者接受了手术内PECs阻塞加局部麻醉或仅局部麻醉.
- 术后疼痛被前性评估.
主要成果:
- 在手术后4小时内,PEC阻断降低了疼痛评分 (1.5比4.5).
- 接受PECs阻塞的患者不太可能需要住院阿片类药物 (10% vs 48%) 或在出院时接受阿片类药物处方 (15% vs 59%).
- 阻断PECs,年龄和缺乏慢性疼痛与下部急性疼痛有关.
结论:
- 在外科手术中阻断PECs有效降低CIED手术后的术后疼痛和阿片类药物消耗.
- 该技术可用于植入医生在手术期间在设备口袋内进行.
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