在的胸部创伤中区域麻醉的模式:系统性审查和贝叶斯网络元分析
Lorenzo Gamberini1, Federico Moro1, Claudia Dallari1
1Department of Anesthesia, Intensive Care and Prehospital Emergency, Ospedale Maggiore Carlo Alberto Pizzardi, Bologna, Italy.
胸部外周麻醉有效减少疼痛,机械通风的持续时间,和住院住院在的胸部创伤患者. 其他区域麻醉技术有希望,但需要进一步研究才能获得明确的结果.
科学领域:
- 麻醉学 麻醉学
- 创伤外科 手术 创伤外科
- 关键护理医学 关键护理医学
背景情况:
- 胸壁的伤害管理仍然是一个挑战.
- 不同区域麻醉技术对重胸部创伤的疗效尚未得到充分证实.
- 在这种情况下,与区域麻醉相关的患者结果需要进一步澄清.
研究的目的:
- 系统地审查和执行贝叶斯网络对区域麻醉技术的贝叶斯网络元分析,用于的胸部创伤.
- 确定最有效的区域麻醉技术,以获得关键患者的治疗结果.
- 为了比较区域麻醉与标准静脉静脉止痛.
主要方法:
- 在Medline,EMBASE,Scopus和Cochrane数据库中系统搜索随机对照试验.
- 包括比较胸部外周治疗,直立脊柱平面阻塞,状骨前面平面阻塞,肋间阻塞,准脊椎阻塞,肌内阻塞,后层阻塞和静脉止痛疗法的研究.
- 贝叶斯网络对结果的元分析,包括疼痛控制,ICU/住院时间,机械通风持续时间,肺炎发病率和止痛药的使用.
主要成果:
- 包括27项随机对照试验,涉及1586名患者.
- 胸部外周麻醉在减少疼痛,机械通风持续时间和ICU/住院时间方面表现出一致的有效性.
- 勃起脊柱平面阻塞还显示了减轻疼痛和住院的好处,对结果的信心低至中等.
结论:
- 胸部外周麻醉是有效的疼痛管理和改善关键结果在的胸部创伤.
- 带平面块正在成为可比缓解疼痛的替代方案,但对其他结果的证据有限.
- 需要进一步的研究来比较不同区域麻醉技术在最终终点上的疗效.
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