在上肢手术中,甲关节下与甲关节上神经阻塞:一个元分析
Guorong Zhang1, Xiaosai Hou, Haonan Wang
1Department of Orthopedics, The Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Monglia, China.
Medicine
|October 29, 2024
概括
与关节神经阻塞相比,关节神经阻塞在上肢手术中提供了优越的止痛效果. 这项系统性审查发现,它显著增加了运动阻塞的持续时间,并降低了对手术的准备.
科学领域:
- 麻醉学 麻醉学
- 区域麻醉 区域麻醉
- 疼痛管理 疼痛管理
背景情况:
- 在上肢手术中,内关节内关节与上关节内关节神经阻塞的比较镇痛效果尚不清楚.
- 这项研究解决了对上肢外科 analgesia 的最佳神经阻塞方法的清晰度的需求.
研究的目的:
- 系统地审查和进行元分析随机对照试验,比较上肢手术中的内关节和上关节神经阻塞.
- 为了评估这两种神经阻断技术的止痛效果,阻断特征和性能时间.
主要方法:
- 在2023年12月之前进行全面的数据库搜索 (PubMed, EMbase, Web of Science, EBSCO, Cochrane).
- 包括随机对照试验 (RCT),重点关注上肢外科手术的内关键骨关节与上关键骨关节神经阻塞.
- 使用基于异质性的固定效应或随机效应模型进行元分析,通过修改的Jadad尺度来评估质量.
主要成果:
- 分析了8个涉及725名患者的RCT.
- 关键管内阻断显著增加了运动阻断的持续时间 (SMD=0.34) 和减少了对手术的准备 (SMD=-0.43).
- 在感觉阻塞的持续时间,阻塞的执行时间或感觉和运动阻塞的发病时间方面没有观察到显著的差异.
结论:
- 下关节神经阻断显示出在上肢手术中控制疼痛的潜在优势,而不是上关节神经阻断.
- 研究结果表明,内关节性阻塞可能在运动阻塞管理和手术准备方面具有优势.
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