在儿科口腔裂变手术中揭开囊上部神经块的神秘性
Matthew Fell1, Lynn Fenner2, Nefer Fallico1
1Spires Cleft Lip and Palate Centre, Salisbury District Hospital, Salisbury, UK.
概括
关上神经 (SZMN) 阻塞是一种安全且可行的区域麻醉技术,用于儿科口腔裂变手术. 这种方法在没有超声波的情况下使用,没有出现并发症,也没有改变患者的阿片类药物使用情况.
科学领域:
- 麻醉学 麻醉学
- 儿科手术 儿科手术
- 区域麻醉 区域麻醉
背景情况:
- 儿童的口腔裂口手术需要有效的疼痛管理.
- 区域麻醉技术可以增强多式模式止痛策略.
- 上关节大神经 (SZMN) 阻塞为手术内和术后止痛提供了一个潜在的方法.
研究的目的:
- 为了评估临床解剖学,安全性和有效性,在儿童患者进行裂口腔手术中,suprazygomatic大神经 (SZMN) 阻塞.
- 描述执行SZMN块的解剖学标志和程序步骤.
- 评估与SZMN阻断相关的术前并发症和术后阿片类药物需求.
主要方法:
- 在一个单一的英国裂中心进行的观察案例系列.
- 包括接受 palatal 手术的儿科患者 (9 个月至 18 岁).
- 在临床方案中引入了用0.2%的罗皮瓦卡因阻断上体上部神经 (SZMN).
主要成果:
- 详细的步骤和图片描述SZMN区块的临床解剖学.
- 43名患者接受了口腔手术;21人除了全身麻醉和局部透外,还接受了SZMN阻塞.
- 没有观察到SZMN阻断的局部或全身并发症;手术后阿片类药物使用在组之间没有显著差异 (P=.79).
结论:
- 上关节神经 (SZMN) 阻塞是一种可行且安全的区域麻醉技术,用于儿科口腔裂变手术,即使没有超声波指导.
- 在这种患者群体中,区域麻醉应该被视为多模式止痛的一部分.
- 证明阿片类药物使用的显著减少可能是具有挑战性的设置,建立了增强的恢复协议和低基线阿片类药物消费的设置.
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