对于接受全膝关节整形手术的患者来说,不同的外围神经阻塞:随机对照试验的网络元分析
Faxing Wang1, Jimin Wu1, Yini Wu1
1Department of Anesthesiology, Lishui People's Hospital, Lishui Hospital of Wenzhou Medical University, No. 1188 Liyang Street, Lishui, Zhejiang, 323000, People's Republic of China.
Archives of orthopaedic and trauma surgery
|October 7, 2024
概括
连续添加管道阻塞与生殖器或IPACK神经阻塞相结合,在全膝关节整形术后治疗疼痛方面表现有前途. 与其他方法相比,这些结合的外围神经阻塞可能会提供更好的疼痛缓解和功能恢复.
科学领域:
- 整形外科手术 整形外科手术
- 疼痛管理 疼痛管理
- 麻醉学 麻醉学
背景情况:
- 膝关节整形术 (TKA) 患者经常经历明显的术后疼痛.
- 外围神经阻断被用来控制疼痛,但最佳的技术需要比较.
研究的目的:
- 对TKA患者进行各种外围神经阻塞的全面比较.
- 评估不同阻断组合对疼痛,功能和不良事件的疗效.
主要方法:
- 在PubMed,Embase,Cochrane图书馆和科学网上进行了系统的文献搜索.
- 包括的研究被分析使用网络图片,森林图片,联赛表和排名概率.
- 评估的结果包括术后疼痛,功能,口服吗啡等效 (OME) 和术后指标.
主要成果:
- 连续添加管道阻断 (cACB) 加上生殖神经阻断 (GNB) 在TKA后24小时和48小时证明对休息疼痛的有效性.
- 像cACB + IPACK + GNB这样的组合块显示出减少运动疼痛的潜力,并改善了定时启动和启动测试 (TUG) 时间.
- 其他组合,如cACB + 神经阻塞 (TNB) 和cACB + IPACK,分别显示出对运动范围 (ROM) 和行走距离的承诺.
结论:
- 结合的外围神经阻断,特别是cACB与IPACK/GNB,似乎对TKA最有利.
- 连续和组合阻塞策略可能比单次射击或单独阻塞技术在术后恢复中具有优势.
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