在视频辅助胸腔镜手术后,cetamol没有改善区域阻断的止痛效果:一项随机对照试验
Sujin Kim1, Seung Woo Song1, Haesung Lee1
1Department of Anesthesiology and Pain Medicine, Wonju College of Medicine, Yonsei University, Wonju, 26426, Korea.
BMC anesthesiology
|January 8, 2025
概括
这项研究发现,在与区域阻塞相结合时,可视频辅助胸部手术 (VATS) 后,青并没有显著改善疼痛控制. 需要进一步的研究来优化VATS患者的疼痛管理策略.
科学领域:
- 麻醉学 麻醉学
- 胸部外科手术 胸部外科手术
- 疼痛管理 疼痛管理
背景情况:
- 视频辅助胸部手术 (VATS) 后的术后疼痛仍然是一个重大的临床挑战.
- 降醇广泛用于止痛,但其在区域块的VATS中的有效性需要进一步研究.
- 现有的临床证据表明,在肺部外科手术中,降醇与区域麻醉技术相结合是有限的.
研究的目的:
- 为了研究胺醇作为VATS后的辅助止痛药的有效性,当与勃起器脊柱平面阻断 (ESPB) 和肋间神经阻断 (ICNB) 结合使用时.
- 为了评估疼痛评分,止痛剂需求,患者满意度,以及接受青醇与安慰剂的患者的不良事件.
主要方法:
- 一个单心,双盲,随机对照试验,涉及90名接受VATS的患者.
- 患者在ESPB和ICNB的同时接受了1g的甲醇或正常盐水.
- 在术后多个时间点使用视觉模拟量表 (VAS) 评估疼痛. 二级结局包括救援止痛剂量,患者满意度以及恶心和吐的发生率.
主要成果:
- 在任何测量时间点 (PACU,6,12,24和48小时) 中,没有观察到VAS疼痛得分在青和安慰剂组之间的统计学上显著差异.
- 患者满意度得分,以及恶心,吐,低血压和心的发病率在两组之间是可比的.
- 这项研究没有证明,当添加到VATS的区域块时,青的镇痛效果优越.
结论:
- 与ESPB和ICNB一起服用的一克青醇在治疗VATS后疼痛方面没有被证明有效.
- 在接受区域麻醉的VATS的患者中,建议在用于疼痛控制的降醇时谨慎使用.
- 可能需要进一步的研究来探索VATS的替代或多模式止痛方法.
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