在经过胸切除术的患者中进行术后止痛:全静脉麻醉和吸入麻醉之间的比较
Joo-Yong Lee1, Soon-Taek Jeong2, Ji-Hye Hwang3
1Joo-Yong Lee, Department of Anesthesiology and Pain Medicine, Chungbuk National University Hospital, Korea.
Pakistan journal of medical sciences
|November 18, 2024
概括
使用propofol-remifentanil的静脉全麻醉在胸切除术后提供了优越的急性疼痛管理,与吸入麻醉相比. 这表明它是胸部手术患者的首选选择.
科学领域:
- 麻醉学 麻醉学
- 胸部外科手术 胸部外科手术
- 疼痛管理 疼痛管理
背景情况:
- 胸切除术后的急性疼痛管理对于患者的康复至关重要.
- 基于propofol的全静脉麻醉与术后疼痛的吸入麻醉的疗效仍在争论中.
研究的目的:
- 为了比较急性术后疼痛的发生率和严重程度,在接受胸切除术和全静脉麻醉 (TIVA) 的患者中,与吸入麻醉相比.
- 评估TIVA与普罗波福-雷米芬坦尼尔在胸部手术中的急性疼痛控制的有效性.
主要方法:
- 在60名接受胸切除术的患者 (ASA I-II) 进行了回顾性观察性研究.
- 2016-2020年期间从电子医疗记录中收集的数据.
- 对TIVA (n=30) 和吸入麻醉 (n=30) 组的术后2,8,24,30小时评估的疼痛评分 (数值评分表).
主要成果:
- 接受TIVA治疗的患者报告说,与吸入麻醉治疗的患者相比,平均疼痛得分较低.
- 在术后8小时观察到疼痛评分的统计学显著差异 (P <0.05).
- 吸入麻醉与更高的疼痛强度和严重程度有关.
结论:
- 使用普罗波福-雷米芬坦尼尔的静脉内全麻醉在胸切除术后的急性术后疼痛中提供优质止痛.
- 这种麻醉方法可以被认为是胸部手术患者治疗疼痛的最佳选择.
相关概念视频
Inhalational Anesthetics: Overview
211
Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...
211
General Anesthesia: Overview
196
Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
196
Local Anesthetics: Clinical Application as Epidural Anesthesia
414
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
414
Stages of General Anesthesia
375
Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
375
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
365
Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
One of the advantages of...
365
Local Anesthetics: Clinical Application as Spinal Anesthesia
584
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
584


