术前胸部外周止痛,有或没有勃起器脊柱平面阻塞用于胸切除术:一项回顾性研究
Tzu-Jung Wei1, Hsin-An Hsu1, Ping-Yan Hsiung2
1Department of Anesthesiology, National Taiwan University Hospital, Taipei City, Taiwan.
Journal of the Formosan Medical Association = Taiwan yi zhi
|February 20, 2025
概括
将勃起器脊柱平面块 (ESPB) 添加到胸部外周止痛疗法 (TEA) 显著减少早期术后疼痛,并改善胸切除术患者的血液动力稳定性. 这种组合提供了比单独TEA更好的疼痛管理.
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:
- 胸切除术会引起严重的疼痛,胸部外周止痛疗法 (TEA) 是标准的疼痛管理方法.
- TEA可能会导致低血压,特别是在全身麻醉中.
- 超声导向勃起器脊柱平面阻塞 (ESPB) 是一种补充技术,用于改善止痛和减少副作用.
研究的目的:
- 为了比较手术前TEA在胸切除术患者中带有和没有ESPB的止痛效果.
- 评估带有和没有ESPB的TEA的手术内血动力学结果.
- 评估ESPB与TEA结合对术后疼痛和稳定性的影响.
主要方法:
- 从2017年3月到2023年3月,对64名胸切除术 (瘤切除) 患者进行了回顾性队列研究.
- 仅接受TEA治疗的患者与接受手术前ESPB治疗的TEA患者之间的比较.
- 倾向性得分匹配创建了1:1匹配组 (每组21名患者),用于分析疼痛得分和血液动力学稳定性.
主要成果:
- 接受ESPB和TEA治疗的患者在1小时和24小时后的术后疼痛得分显著降低 (p < 0.001).
- 与仅服用TEA的组相比,ESPB + TEA组的手术内平均动脉压 (p = 0.036) 较高.
- 两组之间整体术后结果没有显著差异.
结论:
- 术前ESPB与TEA相结合,在胸切除术患者中提供优越的早期术后疼痛控制.
- 与单独使用TEA相比,这种组合增强了手术期间的血液动力稳定性.
- 在胸切除术后,ESPB是TEA优化疼痛管理的宝贵补充.
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