整形外科手术后控制疼痛的连续外围神经阻塞:在住院和门诊护理期间的一项前性研究
Ana María Espinoza1, Patricio A Leyton1, Marcia Robles1
1From the Clínica Alemana - Universidad del Desarrollo Faculty of Medicine (AME, PAL) and Anaesthesia Service, Clínica Alemana de Santiago, Santiago, Chile (AME, PAL, MR, JV, LAM).
European journal of anaesthesiology and intensive care
|February 7, 2025
概括
持续的外围神经阻塞 (CPNB) 在骨科手术后提供无阿片类药物疼痛控制. 家庭使用CPNB是安全有效的,患者满意度高,阿片类药物需求低.
科学领域:
- 麻醉学和疼痛管理
- 整形外科手术 整形外科手术
- 患者护理 患者护理
背景情况:
- 连续的外围神经阻塞 (CPNB) 在骨科手术后提供了无阿片类药物疼痛管理策略.
- 关于出院后患者护理和随访的担忧限制了CPNB的家庭应用.
- 解决医生的担忧是扩大门诊CPNB利用的关键.
研究的目的:
- 评估门诊连续外围神经阻塞 (CPNB) 对于骨科手术患者的可行性和安全性.
- 评估医生对CPNB在门诊环境中的使用的担忧.
主要方法:
- 在一个单一的教学医院进行的前性,观察性队列研究.
- 纳入标准:18岁以上接受骨科手术的患者使用CPNB进行术后疼痛管理.
- 收集了关于疼痛评分,阿片类药物消费和住院和家庭护理期间并发症的数据.
主要成果:
- 497名患者中有387名 (77.87%) 获得了CPNB,并被送回家.
- 在48小时内,70%的人报告轻度或没有疼痛;严重的疼痛很少 (<3.1%).
- 在<13%的患者中需要服用阿片类药物救援药物;13%的患者出现过渡性神经症状,没有严重/长期并发症. 报告显示,患者满意度很高.
结论:
- 由疼痛服务团队监督的医院和家庭CPNB是整形外科手术的安全和可行的选择.
- CPNB有效地管理骨科手术后的疼痛,显著降低了阿片类药物需求.
- 这种方法提高了患者的满意度,并提供了一个可行的阿片类药物节约替代品.
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