在选择性开放性胃切除术后,双边直肠膜封锁与连续布皮瓦卡因输液:一个随机对照试验
Janis Opincans1,2, Igors Ivanovs1,2, Aleksejs Miscuks2
1Department of Surgery, Riga East Clinical University Hospital, 1038 Riga, Latvia.
Medicina (Kaunas, Lithuania)
|January 8, 2025
概括
在开放性胃切除术后,双边直肠膜阻塞与连续布皮瓦卡因输液有效减少了术后疼痛和阿片类药物的使用. 这促进了康复,导致住院时间缩短,改善了患者康复.
科学领域:
- 麻醉学 麻醉学
- 术后恢复 术后恢复
- 疼痛管理 疼痛管理
背景情况:
- 多种模式的止痛疗法有助于在胃切除术后的早期恢复和胃肠功能.
- 开放性胃切除术患者可能会经历明显的术后疼痛和延迟康复.
研究的目的:
- 为了评估双边直肠围膜阻塞 (RSB) 与持续布皮瓦卡因输注的疗效.
- 在开放胃切除术患者中,将RSB与持续布皮瓦卡因输液与安慰剂进行比较.
主要方法:
- 一项随机临床试验,涉及60名接受选择性开放性胃切除术的患者.
- 患者通过双边RSB (A组) 或液安慰剂 (B组) 接收连续布皮瓦卡因输液.
- 主要结局包括阿片类药物消费和视觉模拟尺度 (VAS) 疼痛评分在手术后72小时内.
主要成果:
- 甲组患者报告VAS中位数疼痛得分明显较低 (p < 0.001).
- 没有A组的患者需要救援阿片类止痛药;在最初的12小时内使用了NSAID.
- 组A显著缩短了第一次浮的时间 (p = 0.001),肠道排便 (p < 0.001) 和床外活动 (p < 0.001).
- 总体而言,A组患者的住院时间显著缩短 (p < 0.001).
结论:
- 双边RSB与连续布皮瓦卡因输液是术后疼痛管理的有效策略.
- 这种技术减少了阿片类止痛药的需求,并促进了加速恢复.
- 这种干预措施导致接受开放性胃切除术的患者住院时间缩短.
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