勃起器脊柱平面阻塞可以在剖腹产中取代内吗啡吗? 一个前性随机对照研究关于阿片类药物消费的研究
Betul Yusra Sirin1, Gulsen Teomete2, Beliz Bilgili2
1Department of Anesthesiology and Reanimation, Istanbul Sancaktepe Doctor Ilhan Varank Research and Training Hospital.
The Clinical journal of pain
|January 14, 2025
概括
与勃起器脊柱平面阻塞 (ESPB) 相比,内吗啡 (ITM) 在剖腹产后提供了优异的术后疼痛缓解,显著减少了阿片类药物消耗. 不建议使用ESPB作为剖腹产的主要止痛药.
科学领域:
- 麻醉学 麻醉学
- 产科麻醉 产科麻醉 产科麻醉
- 疼痛管理 疼痛管理
背景情况:
- 剖腹产后最佳的术后止痛对于患者的康复至关重要.
- 有效的疼痛管理促进了早期动员,并降低了血栓栓塞的风险.
- 内吗啡 (ITM) 和直立脊柱平面阻塞 (ESPB) 是剖腹产止痛的潜在选择.
研究的目的:
- 在接受选择性剖腹产的患者中比较ITM和ESPB的术后止痛效果.
- 评估24小时的阿片类药物消费作为主要结果.
- 评估二次结果,包括疼痛评分和不良影响.
主要方法:
- 82名患者被随机分配,在脊髓麻醉后接受ITM或ESPB.
- 两组都接受了布皮瓦卡因的脊髓麻醉; ITM 接受了 100 毫克 ITM,ESPB 接受了双边 T10 阻塞.
- 手术后的疼痛是用青,患者控制的青和迪克洛菲纳克救援止痛药来控制的.
主要成果:
- 数值评分表 (NRS) 疼痛评分在整个24小时术后期间在各组之间是可比的.
- 与ESPB组相比,ITM组的24小时特拉马多尔消费总量明显低于ESPB组 (P=0.008).
- ITM组经历了轻微的副作用 (恶心,吐,),而ESPB组没有报告任何不良事件.
结论:
- 在剖腹产后的术后阿片类药物消耗减少方面,静脉内吗啡比勃起器脊柱平面阻塞更有效.
- 不建议使用ESPB作为剖腹产的首要止痛策略.
- 在剖腹产的背景下,ITM提供卓越的阿片类药物节约性止痛.
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