不同区域麻醉技术对经皮瘤切除术后的术后止痛的影响:系统性审查和网络元分析
Kun Long1, Chengfu Zhou2, Jingqiu Liang2
1Department of Anesthesiology, The Second Xiangya Hospital of Central South University, Changsha, China.
Indian journal of anaesthesia
|March 6, 2025
概括
勃起器脊柱平面阻断 (ESPB),椎阻断 (PVB) 和四度腰部阻断 (QLB) 能够有效地减少皮肤穿神经切除术 (PCNL) 后的疼痛. 与安慰剂相比,这些阻塞提供了显著的止痛效益,它们之间没有显著的差异.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 麻醉学 麻醉学
- 疼痛管理 疼痛管理
背景情况:
- 穿皮骨切除术 (PCNL) 是对结石的一种常见手术.
- 在PCNL之后,最佳的疼痛管理对于患者的康复至关重要.
- 目前PCNL的止痛策略需要进一步研究.
研究的目的:
- 系统地审查和进行PCNL的止痛策略的网络元分析.
- 为了比较PCNL缓解疼痛的各种阻塞和局部透的疗效.
主要方法:
- 在多个数据库 (PubMed,Embase等) 中进行系统搜索. 在2024年1月之前.
- 包括随机对照试验评估勃起器脊柱平面阻塞 (ESPB),椎阻塞 (PVB),肋间神经阻塞 (ICNB),四度腰部阻塞 (QLB) 和局部透.
- 主要结局:24小时的阿片类药物消费和第一次使用阿片类药物的时间;次要结局:疼痛评分和术后恶心/吐.
主要成果:
- 分析包括了27项试验.
- 与安慰剂相比,QLB,PVB和ESPB显著减少了24小时的阿片类药物消费,改善了疼痛得分.
- 在QLB,PVB和ESPB之间没有发现有效性的显著差异.
- 与安慰剂相比,ICNB和局部透没有显著的益处.
结论:
- 对于PCNL来说,ESPB,PVB和QLB是有效的止痛选择,提供了可比的好处.
- 这些阻断剂在PCNL后,与安慰剂相比,提供更好的缓解疼痛.
- 可能需要进一步的研究来澄清ICNB和本地透的作用.
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