编程间歇性玻尿酸勃起器脊柱平面阻塞与肋间神经阻塞在最少入侵的直接冠状动脉旁路手术:一个随机对照试验
Tian Wang1, Xuedong Wang1, Zhuoying Yu1
1Department of Anesthesiology, Peking University Third Hospital, Beijing, China.
BMC anesthesiology
|May 10, 2025
概括
勃起器脊柱平面阻塞 (ESPB) 和肋间神经阻塞 (ICNB) 提供类似的术后疼痛缓解微创直接冠状动脉绕道 (MIDCAB) 手术. ESPB显示了手术期间阿片类药物的使用减少,但整体疼痛评分和止痛药需求在两种技术之间是可比的.
科学领域:
- 麻醉学 麻醉学
- 胸部外科手术 胸部外科手术
- 疼痛管理 疼痛管理
背景情况:
- 连续肋间神经阻断 (ICNB) 是有效的后微侵袭性直接冠状动脉绕道 (MIDCAB) 疼痛.
- 勃起器脊柱平面阻塞 (ESPB) 是胸部止痛的潜在替代方案.
研究的目的:
- 在接受MIDCAB的患者中,比较编程间歇性玻尿酸 (PIB) ESPB与连续ICNB的止痛疗效.
- 为了评估疼痛评分,止痛药消耗和不良事件.
主要方法:
- 预期的,开放标签,随机对照试验,80名MIDCAB患者.
- 患者被随机分配到带有PIB的ESPB或连续ICNB.
- 主要结局:数值评分尺度 (NRS) 疼痛评分在排泄后的运动时.
主要成果:
- 在ESPB和ICNB组之间在NRS疼痛得分 (休息或运动) 中没有显著差异,在任何时间点最长48小时.
- 累积疼痛评分 (AUC) 和需要救援止痛药的情况相似.
- 与ICNB组相比,ESPB组使用的手术内sufentanil显著减少 (p=0.001).
结论:
- 在MIDCAB患者中,ESPB和ICNB的术后止痛效果与MIDCAB患者相似.
- ESPB可能会减少手术期间的阿片类药物需求.
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