在视频辅助胸腔镜外科手术中,状肋间隔膜阻塞是否可以替代状脊椎阻塞? 一个随机的前性研究
Mete Manici1, Belitsu Salgın1, Muhammet Selman Söğüt1
1Department of Anesthesiology and Reanimation, Koç University Hospital, Davutpaşa Caddesi No:4, Topkapı, Istanbul 34010, Turkey.
Diagnostics (Basel, Switzerland)
|October 16, 2024
概括
脊椎间隔阻塞 (RIB) 在视频辅助胸腔镜手术 (VATS) 后提供与椎间隔阻塞 (PVB) 相比的缓解疼痛. 这两种技术都具有相似的止痛效果,使RIB成为VATS疼痛管理的可行替代方案.
科学领域:
- 麻醉学 麻醉学
- 胸部外科手术 胸部外科手术
- 区域麻醉地区麻醉
- 疼痛管理 疼痛管理
背景情况:
- 状肋间阻塞 (RIB) 是一种新兴的面际平面阻塞技术.
- 准脊椎阻塞 (PVB) 是胸腔镜手术的标准区域麻醉.
- 在视频辅助胸腔镜手术 (VATS) 中比较RIB和PVB的止痛效果是临床相关的.
研究的目的:
- 为了比较超声导向的脊椎间隔阻断 (RIB) 与椎间隔阻断 (PVB) 的术后止痛疗效.
- 评估疼痛评分,阿片类药物消耗,以及在接受VATS的患者中拯救止痛药的需求.
主要方法:
- 对84名接受肺癌VATS治疗的成年患者进行前性随机研究.
- 患者接受了超声波引导的RIB或PVB与0.25%的布皮瓦卡因.
- 使用数值评分表 (NRS) 评估的术后疼痛,患者控制的静脉注射芬太尼,青醇和青醇治疗突破性疼痛.
主要成果:
- 在RIB和PVB组之间24小时的阿片类药物总消费没有显著差异 (p=0.258).
- 在两组之间,救援止痛药需求的比例相似 (p=0.570).
- 在RIB和PVB之间,NRS疼痛评分和整体疼痛控制疗效是可比的 (p=0.833).
结论:
- 在视频辅助胸腔镜手术中,状肋间阻塞 (RIB) 显示出与椎间盘阻塞 (PVB) 相当的止痛效果.
- RIB可以被认为是VATS程序的安全和有效的替代止痛方式.
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