在腹部外科手术中,内水晶与横腹腹部平面块对比:一种倾向性得分匹配研究
Yue-Xin Huang1, Yu Chen2, Wei Wang3
1Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, 610041, China.
BMC anesthesiology
|May 9, 2025
概括
与横向腹部平面 (TAP) 块相比,在腹部上部手术后的24小时内,静脉内水晶 (ITH) 在运动期间提供了优异的疼痛缓解. 然而,TAP阻塞在术后的休息疼痛和更早的胃肠道恢复方面显示出更好的结果.
科学领域:
- 麻醉学和疼痛管理
- 术后恢复 术后恢复
- 多模式止痛疗法 多模式止痛疗法
背景情况:
- 多种模式的止痛疗法对于在腹部上部手术后增强康复至关重要.
- 在这些手术中,内摩素 (ITH) 和横腹平面 (TAP) 阻断都是常见的止痛技术.
- 在腹部上部手术中,ITH和TAP阻断之间的比较证据有限.
研究的目的:
- 在接受腹部上部手术的患者中,比较TAP阻断与ITH的止痛效果.
- 为了评估两种技术之间的疼痛强度,止痛药消耗和术后恢复指标.
主要方法:
- 在182名患者中使用倾向分数匹配 (PSM) 的回顾性研究.
- 主要结局:手术后24小时内运动中中度至重度疼痛的发生率.
- 二次结局:休息/运动时疼痛长达72小时,数值评分表 (NRS) 评分,并发症,吗啡等效消耗和康复指标.
主要成果:
- 在ITH组 (24小时) 中,运动时中度至重度疼痛的发病率较低 (27.5%),相比TAP组 (44.0%).
- 在手术后48小时和72小时休息时,ITH组的中位数NRS得分较高.
- 在24小时内增加ITH组的;在TAP组更早的第一次浮;在ITH组较低的第一天吗啡等效.
结论:
- 在腹部外科手术后的前24小时内,内水利 (ITH) 显示出在减少运动引起的疼痛方面具有卓越的疗效.
- 横腹平面 (TAP) 阻断可能在治疗后期术后的休息疼痛和促进早期胃肠道恢复方面具有优势.
- 建议通过随机对照试验进行进一步验证,以建立明确的最佳疼痛管理协议.
相关概念视频
Local Anesthetics: Clinical Application as Spinal Anesthesia
555
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
555
Local Anesthetics: Clinical Application as Epidural Anesthesia
399
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
399
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
329
Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
One of the advantages of...
329


