用直立脊柱平面导管进行持续区域麻醉,用于多重肋骨骨折患者
Anthony Rauschenbach1, Michelle Nguyen1, Dan Lee1
1Department of Emergency Medicine, Hennepin County Medical Center, 730 S 8th St, Minneapolis, MN 55415, USA.
The American journal of emergency medicine
|December 17, 2024
概括
紧急医生放置的连续勃起器脊柱平面 (ESP) 阻断导管减少了肋骨骨折患者的阿片类药物使用. 这种区域麻醉技术对于疼痛管理是安全有效的.
科学领域:
- 紧急医疗 紧急医疗
- 麻醉学 麻醉学
- 创伤外科 手术 创伤外科
背景情况:
- 阿片类药物是肋骨骨折疼痛的标准,但具有成和呼吸系统风险.
- 勃起器脊柱平面 (ESP) 块提供了一个有前途的阿片类药物节约替代品.
- 紧急医生 (EP) 进行ESP导管连续输注需要对疗效和安全性进行评估.
研究的目的:
- 评估连续输入罗皮瓦卡因ESP导管的有效性和安全性,这些导管由EPs放置.
- 为了比较多重单边肋骨骨折患者的阿片类药物使用和患者结局.
主要方法:
- 对多重创伤患者与肋骨骨折 (2019-2020) 的回顾性病例对照研究.
- 治疗组:通过EP安置ESP导管;对照组:没有区域麻醉.
- 主要结局:阿片类药物使用 (MMED);次要结局:住院时间,输管率,并发症.
主要成果:
- 每组89名患者;在治疗组中,阿片类药物使用减少了导管后安置 (89至67MMED,P=0.003).
- 治疗组和对照组之间整体阿片类药物使用没有显著差异 (P=0.57).
- 在孤立的肋骨骨折患者中减少机械呼吸和更短的住院时间的趋势,不具有统计学意义.
结论:
- 通过EP的持续ESP导管放置是安全的,没有重大并发症.
- 使用ESP导管导致手术后减少阿片类药物消费.
- 阻断ESP是肋骨骨折疼痛管理的安全补充,尽管整体阿片类药物使用在各组之间没有显著差异.
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