区域麻醉与自发呼吸用于胸部出口综合征的横轴手术:一个回顾性比较研究
Francesco Stilo1,2, Alessandro Strumia3, Vincenzo Catanese1
1Vascular Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200-00128 Roma, Italy.
Journal of clinical medicine
|January 25, 2025
概括
区域麻醉 (RA) 用于胸部出口综合征 (TOS) 手术,使用超关节腕和胸部神经阻塞,减少疼痛和阿片类药物的使用与全身麻醉 (GA) 相比. 这种方法也缩短了手术和住院时间.
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:
- 胸腔出口综合征 (TOS) 需要在保守治疗失败时进行手术减压.
- 评估麻醉技术对于优化TOS患者手术结果至关重要.
研究的目的:
- 为了比较区域麻醉 (RA) 与全身麻醉 (GA) 的疗效和安全性,用于TOS手术.
- 评估疼痛评分,阿片类药物消耗和经过TOS第一个肋骨切除术的患者的术后结果.
主要方法:
- 对68名接受TOS第一个肋骨切除术的患者进行了回顾性比较研究.
- 患者被分为GA (n=29) 和RA (n=39) 组.
- 关节性关节炎涉及脑关节上臂 (SBP) 和胸部神经 (PECS II) 阻塞与深度镇静.
主要成果:
- RA 组显示术后疼痛显著降低 (NRS 0 与 2,p=0.0443) 和减少手术内/术后阿片类药物消耗 (p<0.001,p=0.0418).
- RA 与手术持续时间缩短 (p=0.0008),手术后恶心和吐 (PONV) 减少 (p=0.0312),以及手术内肺损伤减少 (p<0.0001).
- RA 组的住院时间显著缩短.
结论:
- 使用SBP和PECS II块的区域麻醉 (RA) 对TOS手术的全身麻醉 (GA) 具有显著的优势.
- RA 改善了外科手术期间的结果,包括疼痛控制,阿片类药物减少和并发症率.
- 需要进一步的前性研究来确认TOS手术中RA的长期结果.
相关概念视频
Local Anesthetics: Clinical Application as Spinal Anesthesia
573
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
573
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
352
Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
One of the advantages of...
352
General Anesthesia: Overview
190
Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
190
Pneumothorax-II
118
Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
Clinical Manifestations:
118


