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在视频辅助胸腔镜手术中对准脊椎阻塞进行不同辅助止痛的比较:双盲随机对照试验

Rong Tang¹, Wen-Sheng Lu¹, Hai-Lian Zhong¹

¹Department of Anesthesiology, The Second Hospital of Lanzhou University, Lanzhou, China.

|May 2, 2025

概括

德克斯梅德托米丁作为胸部副脊椎阻塞 (TPVB) 中罗皮瓦卡因的辅助剂,为视频辅助胸腔镜手术 (VATS) 提供了卓越的疼痛缓解. 这种辅助疗法可以促进康复,并减少住院时间,与其他选择相比.

科学领域:

麻醉学麻醉学
疼痛管理疼痛管理
胸部外科手术胸部外科手术

背景情况:

局部麻醉辅助剂可以改善疼痛缓解,并延长疼痛缓解.
关于视频辅助胸腔镜外科手术 (VATS) 中胸腔副脊椎阻塞 (TPVB) 的辅助疗效的数据有限.

研究的目的:

为了比较德克斯梅托米丁,德克萨米他松和苏芬坦尼尔作为辅助剂对罗皮瓦卡因的止痛效果,在对VATS的超声导向TPVB中进行了超声导向TPVB.
评估这些辅助剂对术后疼痛,阿片类药物消耗和恢复质量的影响.

主要方法:

接受VATS的120名患者被随机分为四组:单独使用罗皮瓦卡因 (对照组),使用罗皮瓦卡因与德克斯梅托米丁,使用罗皮瓦卡因与德克萨美,或使用罗皮瓦卡因与苏芬坦尼尔.
用超声波引导的TPVB进行了管理. 主要结局包括多个时间点的视觉模拟尺度 (VAS) 疼痛评分.
二次结果评估了阿片类药物的使用,患者控制的静脉静脉止痛 (PCIA) 需求,救援止痛,副作用,康复质量和住院时间.

主要成果:

所有辅助剂组在术后12-20小时显示,与对照组相比,VAS疼痛得分降低.
辅助药物降低了术后阿片类药物消费,PCIA使用,并改善了行走时间.
与德克萨米他和sufentanil相比,德克萨米他在减少止痛药,胸管持续时间和住院时间方面表现出更高的疗效.

结论:

使用TPVB的辅助止痛疗法有效地改善了VATS患者的术后疼痛管理.
德克斯梅德托米丁比德克萨米他和苏芬坦尼尔具有更好的益处,包括延长疼痛缓解,减少对止痛药的需求,提高康复质量和缩短住院时间.

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