儿童心胸外科手术中的区域性止痛:贝叶斯网络元分析
Yi Ren1, Lijing Li1, Jingchun Gao2
1Department of Anesthesiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, China.
Journal of cardiothoracic and vascular anesthesia
|January 29, 2025
概括
区域性止痛药有效地减少了儿科心胸外科手术中术后阿片类药物的使用. 胸部回膜阻塞显示了最大的阿片类药物减少,而外周麻醉尽量减少恶心和吐.
科学领域:
- 麻醉学 麻醉学
- 儿科手术 儿科手术
- 疼痛管理 疼痛管理
背景情况:
- 在儿科心胸外科手术中,术后疼痛管理至关重要.
- 用各种区域性镇痛技术来缓解疼痛.
- 确定这些技术的比较有效性至关重要.
研究的目的:
- 在接受心胸外科手术的儿科患者中比较不同区域止痛干预措施的相对疗效.
- 为了评估阿片类药物的消费,疼痛评分,第一次救援止痛药的时间,以及术后的恶心和吐.
主要方法:
- 在PubMed,EMBASE,Web of Science和Cochrane数据库中的系统文献搜索.
- 包括24项随机对照试验,包括1602名儿科患者.
- 贝叶斯网络元分析 (NMA) 来比较13个区域区块.
主要成果:
- 所有区域区块都在术后24小时内表现出阿片类药物节约作用.
- 胸部逆膜阻断产生了最大的阿片类药物消费减少 (WMD -0.97 mg/kg吗啡等效).
- 外周麻醉显示术后恶心和吐的发病率最低,其次是横侧胸部肌肉平面阻塞.
结论:
- 区域麻醉在儿科心胸外科手术中提供了显著的阿片类药物节约益处.
- 胸部逆膜阻塞和外周麻醉对特定结果显示有希望.
- 由于现有研究的异质性,需要进行进一步的直接比较研究.
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