上干与手臂手臂手腕手术中的干间阻:一个随机对照试验
Chandni Sinha1, Poonam Kumari1, Ajeet Kumar1
1All India Institute of Medical Sciences, Patna, India.
Anaesthesiology intensive therapy
|October 25, 2024
概括
上部干部 (ST) 块提供了可比的疼痛缓解到关节 (IS) 块的部手术,但与明显更少的腹膜. 这种超声波引导的技术是一种更安全的替代方案,特别是对于呼吸系统问题患者.
科学领域:
- 麻醉学 麻醉学
- 区域麻醉地区麻醉
- 超声波引导的程序 超声波引导的程序
背景情况:
- 超声波 (US) 引导的间层 (IS) 阻塞是肩膀和手腕手术的标准,提供有效的疼痛缓解.
- 然而,IS阻塞与半膜体和呼吸障碍有关,对一些患者构成风险.
- 顶部干部 (ST) 阻断,准C5和C6神经根,是一种替代方法.
研究的目的:
- 为了比较ST阻断与IS阻断在近腰手术中的止痛效果.
- 为了评估与每个阻断技术相关的隔膜的发生率.
- 为了确定ST阻断是否是一种更安全的替代方案,具有类似的疼痛控制.
主要方法:
- 一项随机对62名患者进行的随机研究,这些患者接受了近腰/中腰骨骨折固定.
- 患者接受了美国指导的ST阻断或美国指导的IS阻断,用0.5%的布皮瓦卡因.
- 隔膜外流,疼痛评分 (数值评分表) 和阿片类药物消耗在术后进行了评估.
主要成果:
- 与IS区块相比,ST区块的完全和部分隔膜的发生率明显较低 (0%对38%完全,19%对62%部分).
- 两种ST和IS块都提供了类似的术后疼痛评分和阿片类药物需求.
- IS 块显示,隔膜运动的减少比 ST 块更大.
结论:
- 在近端/中部腰椎手术中,ST块提供了与IS块相似的止痛效果.
- ST 块显著地比IS 块更好地保留隔膜功能.
- ST阻塞是接受手臂手术的患者,特别是呼吸系统受损的患者的可行和潜在的更安全的替代方案.
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