在到达时连续的臂阻断提供优越的止痛,减少复杂的手部伤害中持续的术后疼痛:一项随机对照试验
Kajal Kashyap1, Nidhi Bhatia, Kajal Jain
1From the Department of Anesthesia and Intensive Care (K.K., N.B., K.J., K.S., M.K., R.N.), and Department of Plastic Surgery (S.G., T.G.), Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
The journal of trauma and acute care surgery
|March 13, 2025
概括
与全身止痛药相比,连续的臂阻断显著降低了疼痛,并改善了复杂的手部损伤的恢复. 这种技术提供了优越的疼痛管理和较低的持续性术后疼痛.
科学领域:
- 创伤外科 手术 创伤外科
- 疼痛管理 疼痛管理
- 区域麻醉地区麻醉
背景情况:
- 复杂的手部伤害会导致严重的疼痛和长时间的手术前等待期.
- 急性创伤管理需要有效的疼痛控制策略.
- 连续的外围神经阻塞是急性创伤疼痛的潜在解决方案.
研究的目的:
- 评估连续臂阻塞与静脉注射止痛药在急性复杂手部损伤的疼痛管理中的疗效.
- 为了比较两组之间的疼痛评分,止痛剂需求和持续的术后疼痛.
主要方法:
- 80名患有复杂单边手部损伤和中度至重度疼痛的成年患者被随机分为两组.
- 干预组使用罗皮瓦卡因连续接受了脑内脉阻断 (BPB) 治疗.
- 对照组接受了静脉注射的白醇和迪克洛芬雅克.
主要成果:
- 在BPB组中的100%的患者报告疼痛得分<4干预后一个小时,而对照组的57.5% (p=0.00).
- 在BPB组中,没有患者在伤口护理过程中感到疼痛,而对照组中的55% (p=0.00) 没有.
- BPB组在15天和30天 (p=0.03) 的持续性术后疼痛 (PPSP) 显著减少 (p=0.03).
结论:
- 连续的臂阻断为复杂的手部创伤提供了卓越和一致的疼痛缓解.
- 早期实施连续的外围神经阻塞应纳入创伤疼痛管理协议.
- 这种技术可以减少持续的术后疼痛,并提高患者在手术期间的舒适度.
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