对于急性胸部疹的神经阻断的有效性和安全性Zoster:系统性审查和元分析
Chiao-Ming Chuang1, Chung-Ren Lin1, Yu-Lien Hsieh1
1Department of Anesthesiology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City, Republic of China.
神经阻塞有效地管理急性疹疼痛,并减少后神经疼痛 (PHN) 的发生率. 建议使用超声导向勃起器脊柱平面 (ESP) 块,以确保其安全性和有效性.
科学领域:
- 疼痛管理 疼痛管理
- 区域麻醉地区麻醉
- 神经学 神经学
背景情况:
- 急性疹疼痛影响超过90%的患者.
- 神经阻塞在其他类型的疼痛中很常见,但在急性疹中未被充分研究.
研究的目的:
- 评估神经阻塞对急性黄疹病毒的疗效和安全性.
- 为了比较不同的神经阻断技术.
主要方法:
- 对RCT和观察性研究进行系统审查和元分析.
- 在 MEDLINE,Embase 和 Cochrane 数据库中进行了搜索.
- 评估了镇痛功效,PHN发生率和不良事件.
主要成果:
- 神经阻塞在4周内显著降低了疼痛评分和止痛药的需求.
- 准脊椎阻塞 (PVB) 和勃起脊柱平面 (ESP) 阻塞在3个月和6个月减少PHN发生率.
- 超声导向ESP阻断显示显著减少疼痛和PHN预防,没有重大不良事件.
结论:
- 神经阻塞提供有效的止痛,并减少PHN发生在急性胸部疹中.
- 由于安全原因,建议使用ESP块;PVB提供了类似的好处,但风险更高.
- 需要更多的高质量的RCT用于肋间间和外周阻塞.
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