在开放性胰腺二管切除术中,持续的腹前与胸外外麻醉:随机临床试验
Mirang Lee1,2, Ji-Yoon Jung3,4, Youngmin Han1
1Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
The British journal of surgery
|November 27, 2024
概括
持续的伤口透 (CWI) 与胸部外周止痛疗法 (TEA) 不逊于治疗胰腺切除术后的术后疼痛. CWI在术后第三天提供更好的疼痛缓解和增强的恢复.
科学领域:
- 麻醉学 麻醉学
- 手术疼痛管理手术疼痛管理
- 术后恢复 术后恢复
背景情况:
- 胸外外麻醉 (TEA) 是主要腹部手术疼痛的标准,但会导致并发症.
- 前腹膜连续性伤口透 (CWI) 为术后疼痛管理提供了一个有希望的替代方案.
研究的目的:
- 为了比较CWI与TEA在开放性胰腺切除术后对疼痛控制的有效性.
- 评估CWI在治疗早期术后疼痛方面对TEA的非劣势.
主要方法:
- 一个单中心的,随机的,开放标签的非劣势性试验,涉及接受开放性胰腺切除术的成年患者.
- 主要结局:术后1-3天 (11点NRS) 休息时的平均疼痛得分. 非劣势差额:1个点.
- 二次结果:咳时的疼痛,阿片类药物消费,并发症,康复质量和住院时间.
主要成果:
- 对于休息时的平均疼痛得分,CWI与TEA不逊色 (平均差异为-0.13).
- CWI在休息时显示出优异的疼痛缓解,并在术后第3天获得更好的康复得分.
- 与CWI相比,TEA降低了阿片类药物的消费量和充血时间,但增加了低血压风险.
结论:
- 持续的伤口透 (CWI) 是一个非劣质的,有利的替代方案,胸部外周止痛 (TEA) 早期术后疼痛.
- CWI可以更好地缓解疼痛,并在胰腺二切除术后的第三天进行术后恢复.
- 进一步的研究可能会探索CWI的长期结果和更广泛的应用.
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