静脉注射与周围神经甲松的比较超声波导向勃起器脊柱平面阻塞在经过修改的激进乳房切除术的患者 - 一个随机对照试验试验
Gokila Devrajan1, Priyanka H Chhabra1, Sushil Guria1
1Department of Anaesthesiology and Critical Care, VMMC and Safdarjung Hospital, Delhi, India.
Journal of anaesthesiology, clinical pharmacology
|April 18, 2025
概括
与静脉注射德克萨米他相比,围性德克萨米他显著延长了缓解疼痛的持续时间,并减少了经过修改的激进乳房切除术后的吗啡使用. 这种辅助剂增强了勃起器脊柱平面阻断在术后疼痛管理中的有效性.
科学领域:
- 麻醉学 麻醉学
- 疼痛管理 疼痛管理
- 区域麻醉地区麻醉
背景情况:
- 德克萨米他是一种助剂,用于延长外围神经阻塞的持续时间.
- 勃起器脊柱平面阻塞 (ESPB) 与罗皮瓦卡因用于修改激进乳房切除术 (MRM) 的疼痛控制.
- 作为ESPB的辅助剂,德克萨米他的最佳注射途径仍在调查中.
研究的目的:
- 为了比较周围神经与静脉注射德克萨米他的疗效,作为MRM患者ESPB的罗皮瓦卡因辅助剂.
- 评估德克萨米他的施用途径对疼痛缓解和术后阿片类药物消费的持续时间的影响.
主要方法:
- 一项前性,双盲,随机化研究,涉及60名接受MRM的女性患者.
- 患者接受了周围神经甲松 (RPD),静脉注射甲松 (RID) 或正常盐水 (RNS) 与0.5%的罗皮瓦卡因ESPB.
- 使用数值评分表 (NRS) 评估疼痛,并记录了救援止痛和吗啡消耗的时间.
主要成果:
- 周围神经甲松 (RPD) 组显示,与静脉注射甲松 (RID,435分钟) 和对照 (RNS,360分钟) 组相比,第一次救援止痛的中位数时间 (720分钟) 显著更长 (P=0.01).
- RPD显示了24小时中位数最低的吗啡消耗量 (2.0毫克) 与RID (6.0毫克) 和RNS (7.5毫克) 相比 (P=0.01).
- 在所有测量时间点中,在RPD组中观察到更低的NRS休息和活动期间的疼痛得分.
结论:
- 周围神经甲松,当用于ESPB的罗皮瓦卡因辅助剂时,显著延长了镇痛的持续时间.
- 与静脉注射德克萨米他相比,这种施用途径还导致手术后吗啡消耗减少和疼痛评分降低.
- 围神经德克萨米他是一种优秀的辅助剂,可以提高ESPB在接受MRM的患者的有效性.
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