宫结阻断增强疼痛控制为甲状腺结节的单方面热切除除
Matrix Man Him Fung1, Yan Luk1, Brian Hung Hin Lang1
1Department of Surgery, the University of Hong Kong, Queen Mary Hospital, Hong Kong, China.
在甲状腺结节的热废除 (TA) 麻醉中添加椎结质阻塞 (CPB),显著降低了术后疼痛. 这种增强的疼痛管理没有影响患者的康复或当天出院.
科学领域:
- 内分泌学 在内分泌学.
- 疼痛管理 疼痛管理
- 最少侵入性手术的方法
背景情况:
- 甲状腺结节的热切除除术 (TA),虽然侵袭性最小,但可以引起显著的术后疼痛.
- 目前的疼痛管理依赖于带有或没有镇静的甲状腺周围局部麻醉 (PLA).
- 椎结质阻塞 (CPB) 已被确立用于甲状腺切除术,但尚未研究TA.
研究的目的:
- 为了研究超声波引导的CPB添加到PLA和镇静剂的疗效,以减少甲状腺结节单边TA后的术后疼痛.
- 评估CPB对TA患者疼痛评分和康复质量的影响.
主要方法:
- 一项对100名接受单边射频或微波切除甲状腺结节的患者进行的比较研究.
- 第一组 (n=50) 接受标准PLA和镇静;第二组 (n=50) 接受了额外的超声波引导CPB.
- 使用数值评分尺度 (NRS) 评估疼痛,立即和4小时后;还评估了恢复质量-9 (QoR9).
主要成果:
- 与I组相比,II组的立即NRS (1vs4) 和4小时NRS (1vs2) 疼痛评分明显较低.
- 在II组的患者中,更高的百分比实现了零即时疼痛 (44%对14%).
- 恢复质量 (QoR9分数) 和当天出院率在各组之间是可比的,没有报告的不良事件.
结论:
- 超声指导的CPB是PLA和镇静的有效补充,用于改善单方面甲状腺结节切除后的术后疼痛控制.
- 添加CPB可以增强疼痛缓解,但不会对患者的康复或当天出院的能力产生负面影响.
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