上背部,部和肩部疼痛在分娩期间外周止痛:一个质量改进倡议
R Achu-Lopes1, L C Tsen2, G Ovsak2
1Department of Anesthesiology, Boston Medical Center, Boston University School of Medicine, Boston, MA, United States.
International journal of obstetric anesthesia
|September 10, 2024
概括
产后外周止痛 (PLEA) 期间的疼痛影响了1.2%的女性,通常是年轻的,体重指数较高的无卵性个体. 一个新的三步方案有效地管理了PLEA疼痛,降低了NRS得分并改善了结果.
科学领域:
- 产科和妇科 产科和妇科
- 麻醉学 麻醉学
- 疼痛管理 疼痛管理
背景情况:
- 在分娩期间严重的上背部,部和肩部疼痛,外周止痛 (PLEA) 是一种已知的并发症.
- PLEA的发病率和管理需要进一步调查,以改善患者的护理.
研究的目的:
- 评估PLEA的发病率和人口统计学关联.
- 评估PLEA新实施的三步治疗方案的有效性.
主要方法:
- 一个单一的中心,为期八个月的质量改进计划.
- 基于专家共识的三步PLEA治疗方案的实施.
- 人口统计数据的比较和妇女与没有PLEA之间的结果.
主要成果:
- PLEA发生在接受分娩外周止痛药的1.2%的妇女中.
- 患有PLEA的女性更年轻,更经常无卵性,BMI更高.
- 这三步方案成功地减少了疼痛 (NRS中位数为9至3),并与较高的剖腹产分娩率有关.
结论:
- PLEA的发病率高于之前报告的.
- 较年轻的,BMI较高的女性更容易受到PLEA的影响.
- 一个结构化,三步治疗方案有效地管理PLEA并改善疼痛评分.
相关概念视频
Local Anesthetics: Clinical Application as Epidural Anesthesia
422
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
422
Local Anesthetics: Clinical Application as Spinal Anesthesia
592
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
592


