勃起器脊柱平面阻塞在接受切术的患者中的止痛作用:随机对照试验的系统审查和元分析
Ahmed A Abo Elnaga1, Abdelrahman M Elettreby2, Omnia Samy El-Sayed3
1Faculty of Medicine, Mansoura University, Mansoura, Dakahlia, Egypt. ahmedabdallah14@std.mans.edu.eg.
World journal of urology
|May 8, 2025
概括
勃起器脊柱平面阻塞 (ESPB) 显著降低了切术后的术后疼痛,减少了阿片类药物使用和恶心. 需要进一步的研究来证实这些止痛作用.
科学领域:
- 麻醉学 麻醉学
- 区域麻醉地区麻醉
- 疼痛管理 疼痛管理
背景情况:
- 在腎切除術後的術後疼痛管理帶來了重大挑戰.
- 勃起器脊柱平面块 (ESPB) 是一种区域性镇痛技术,有可能有效缓解疼痛.
- 与其他区域麻醉方法相比,ESPB以其相对简单而闻名.
研究的目的:
- 为了评估ESPB在接受切除术的患者的止痛效果.
- 为术后疼痛管理提供基于证据的指导.
- 评估ESPB对疼痛评分,阿片类药物消费和不良事件的影响.
主要方法:
- 在主要数据库 (PubMed,Scopus,Web of Science,Cochrane Library) 进行了系统的文献搜索,直到2024年9月.
- 14项涉及897名患者的临床试验被纳入了分析.
- 使用偏见风险工具来确保对证据质量的强有力的分析.
主要成果:
- 与没有阻断 (p < 0.00001) 相比,ESPB显著降低了休息和中间恢复阶段 (长达 12 小时) 的术后疼痛评分 (p < 0.00001).
- 在术后24小时观察到显著的疼痛减轻 (SMD = -0.65,p < 0.0001).
- 在ESPB组中,阿片类药物消费量减少 (MD = -29.56 mg,p < 0.00001),第一次救援止痛的时间更长 (SMD = 3.56 分钟,p = 0.001),术后恶心和吐的发生率更低.
结论:
- 这一系统性审查证实ESPB在切除术后具有显著的术后止痛益处.
- ESPB与减少阿片类药物需求以及手术后恶心和吐的风险较低有关.
- 迫切需要进一步的高质量研究来巩固这些发现并指导临床实践.
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