改善胸部创伤护理:重症监护病房的局部区域性止痛疗法
Guilherme Sousa1, André Barbosa Ribeiro2, Elena Segura-Grau1
1Anesthesiology, Unidade Local Saúde Viseu Dão-Lafões, Viseu, PRT.
Cureus
|January 1, 2025
概括
胸部创伤患者的局部麻醉/疼痛缓解 (LRAA) 可以帮助避免侵入性机械通风,并缩短ICU停留时间. 早期LRAA的应用显示出在重症监护机构改善治疗结果的希望.
科学领域:
- 麻醉学 麻醉学
- 关键护理医学 关键护理医学
- 创伤外科 手术 创伤外科
背景情况:
- 胸部创伤的传统疼痛管理依赖于全身阿片类药物,经常引起不良影响.
- 局部麻醉/疼痛缓解 (LRAA) 提供了一种针对性的方法来缓解受伤部位的疼痛.
研究的目的:
- 调查LRAA对疼痛管理和重症监护室 (ICU) 胸部创伤患者的临床结果的影响.
- 评估LRAA在减轻疼痛和影响ICU相关结果方面的有效性.
主要方法:
- 对33名胸部创伤患者的43次LRAA手术的回顾性分析.
- 排除了14项与胸部创伤无关的手术.
- 包括一些技术,如胸部外周,直立脊柱和状平面块.
主要成果:
- 在侵袭性机械通风 (IMV) 之前接受LRAA的50%的患者避免了输内管 (p<0.05).
- 在IMV之前的LRAA与显著缩短的ICU停留时间有关 (中位数为9天与13天,p=0.05).
- 没有观察到LRAA导管的严重并发症,使用时间平均为7天.
结论:
- 在ICU胸部创伤患者中,LRAA显示出改善临床结果的潜力.
- 早期LRAA申请可能会减少对IMV的需求,并缩短ICU停留时间.
- 需要进一步的研究才能充分了解LRAA的影响,特别是在LRAA后需要IMV的患者中.
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