在选择性视频辅助胸部手术后比较勃起器脊柱平面 (ESP) 和胸部副脊柱 (TPV) 阻断止痛效果:一个随机的,多重盲目的,非劣势试验
Roberto Dossi1, Miriam Patella2, Barbara Barozzi1
1Department of Anaesthesia, San Giovanni Hospital, Bellinzona, Switzerland.
Journal of thoracic disease
|April 14, 2025
概括
这项研究发现,在视频辅助胸部手术 (VATS) 后的疼痛中,勃起器脊柱平面 (ESP) 和胸部副脊椎 (TPV) 阻塞之间,阿片类药物使用没有显著差异. 这两种方法都提供了有效的疼痛管理替代方案,而不是胸部外周止痛.
科学领域:
- 胸部外科手术 胸部外科手术
- 疼痛管理 疼痛管理
- 区域麻醉地区麻醉
背景情况:
- 视频辅助胸部手术 (VATS) 是最小侵入性肺切除的标准.
- 在VATS之后的术后疼痛可能会导致并发症.
- 胸部外周止痛疗法 (TEA) 是有效的,但具有侵入性;像勃起器脊柱平面 (ESP) 和胸部副脊椎 (TPV) 等不那么具有侵入性的阻塞正在研究中.
研究的目的:
- 为了比较ESP阻断与TPV阻断在VATS后术后疼痛管理的疗效.
- 为了确定ESP阻断是否在减少阿片类药物消费方面不劣于TPV阻断.
主要方法:
- 一个单中心的,随机的,多重盲目的,受控的,非劣势试验.
- 接受VATS的50名患者被随机分为两组:Anest ESP (局部麻醉阻断ESP,用盐水阻断TPV) 和Sham ESP (用盐水阻断ESP,用局部麻醉阻断TPV).
- 主要结局:术后24小时和48小时累积的救援阿片类药物剂量.
主要成果:
- 分析了47名患者的数据.
- 在24小时 (P=0.09) 和48小时 (P=0.12) 的阿尼斯特ESP和虚假ESP组之间,阿片类药物消费没有统计学上显著的差异.
- 心肺复杂症和手术时间较低,在不同组之间可比.
结论:
- 该研究没有证明ESP块与TPV块相比,在VATS后的术后止痛方面,ESP块的非劣势性.
- 阻断ESP和TPV都提供了有效的疼痛缓解,结果没有显著差异.
- 无论是ESP还是TPV块都是TEA的可行的替代方案,用于VATS疼痛管理.
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