修改后的胸腔腹部神经通过周粒体来阻断是有效的,以减少手术后的阿片类药物需求,在患者进行腹腔镜胆囊切除术:一个分析与试验顺序分析分析
Alessandro DE Cassai1, Burhan Dost2, Dario Bugada3
1Sant'Antonio Anesthesia and Intensive Care Unit, University Hospital of Padua, Padua, Italy.
Minerva anestesiologica
|February 5, 2025
概括
修改后的胸腔腹部神经通过周心脏接近 (M-TAPA) 阻断显著减少了术后阿片类药物使用和腹腔镜胆囊切除术 (LC) 后的疼痛. 这种区域麻醉技术还可以降低恶心,吐和救援止痛药的发生率.
科学领域:
- 麻醉学 麻醉学
- 区域麻醉地区麻醉
- 疼痛管理 疼痛管理
背景情况:
- 经过修改的胸腔腹部神经通过周粒体方法阻断 (M-TAPA) 是一种区域麻醉技术.
- 它已被提议用于减少腹腔镜胆囊切除术 (LC) 中的术后阿片类药物消耗.
研究的目的:
- 在接受LC的患者中评估M-TAPA阻断剂的止痛效果.
- 本系统性审查和元分析旨在评估M-TAPA对疼痛和阿片类药物使用的影响.
主要方法:
- 我们对PubMed,Scopus和Cochrane Central进行了系统的搜索.
- 包括的研究比较了M-TAPA阻断与假阻断,安慰剂或没有干预.
- 主要结局是手术后24小时的阿片类药物消费;次要结局包括疼痛评分,PONV和救援止痛药.
主要成果:
- 分析了6项涉及350名患者的研究.
- M-TAPA显著降低了手术后的阿片类药物消费 (MD -9.06).
- 观察到较低的疼痛评分,降低PONV (OR 0.19),以及降低救援止痛需求 (OR 0.24).
结论:
- 与LC中的对照组相比,M-TAPA阻断提供了优异的止痛效果.
- 该技术有效地管理术后疼痛,并减少阿片类药物需求.
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