在联合脊柱外周麻醉和全身麻醉下进行 laparoscopic 完全外皮带内 Hernia 修复
Turgut Donmez1, Evrim Kucur Tulubas2, Ipek Bostanci3
1Departments of General Surgery.
Surgical laparoscopy, endoscopy & percutaneous techniques
|December 5, 2024
概括
结合脊柱和外周麻醉 (CSEA) 为 inguinal 修复提供了全身麻醉的安全替代方案,显著减少术后疼痛和止痛需求. 这项研究突出了CSEA的重点.
科学领域:
- 麻醉学 麻醉学
- 手术瘤学手术瘤学
- 疼痛管理 疼痛管理
背景情况:
- 阴带修复是全世界常见的选择性手术.
- 总麻醉 (GA) 带有风险,包括恶心,吐和术后疼痛.
- 与GA相比,区域麻醉 (RA) 提供了诸如更快的恢复和减少并发症等优势.
研究的目的:
- 评估结合脊柱和外周麻醉 (CSEA) 的有效性和安全性,以预防完全外皮漏 (TEP) 期间的肩部疼痛.
主要方法:
- 在2020年4月至2021年11月期间,对81名因 inguinal 而接受 TEP 的患者进行了回顾性审查.
- 患者被分为两组:全身麻醉 (GA) 和结合脊柱外周麻醉 (CSEA).
- 收集的数据包括人口特征,手术时间,手术时间,腹裂发生率,肩膀疼痛,VAS分数,止痛需要和麻醉并发症.
主要成果:
- 在40名GA患者和41名CSEA患者之间没有显著的人口差异.
- 手术和手术时间相似,尽管GA组的手术时间显著缩短 (P<0.001).
- 在CSEA组,VAS得分显著降低,术后止痛的需要减少 (P<0.001),只有1名患者出现轻度肩部疼痛. 头痛发生在15%的CSEA组,而在GA组为0% (P=0.012).
结论:
- 结合脊柱和外周麻醉 (CSEA) 是腹腔镜TEP手术中全身麻醉的可行替代方案.
- 通过CSEA获得的好处包括降低疼痛评分,降低止痛剂的需求,以及可能减少肺部并发症.
- 进一步的研究可能会探索优化CSEA协议以减轻头痛等副作用.
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