区域麻醉技术用于严重胸壁创伤的管理:一个主要的创伤中心回顾性观察性研究
Sofia Rosas1, Jillian Scott1, Malcolm J Watson1,2
1Department of Anaesthesia and Critical Care Medicine, Queen Elizabeth University Hospital, Glasgow, UK.
概括
胸壁创伤区域麻醉 (RA) 显著改善呼吸支和氧化,同时减少阿片类药物需求. 这项研究支持在严重的胸部创伤中使用RA,特别是当肋骨固定延迟时.
科学领域:
- 麻醉学 麻醉学
- 创伤外科 手术 创伤外科
- 疼痛管理 疼痛管理
背景情况:
- 肋骨骨折的胸壁创伤带来了重大的麻醉挑战,往往导致阿片类药物使用增加,低通风和呼吸道并发症.
- 区域麻醉 (RA) 技术提供了一种潜在的解决方案,通过改善氧化和减少阿片类药物需求来减轻这些问题.
研究的目的:
- 描述了一组因胸壁受伤而接受RA阻塞的创伤患者队列.
- 评估RA技术对呼吸支,阿片类药物消耗和患者结局的影响.
主要方法:
- 从2018年10月至2022年8月期间接受了RA导管安置的胸壁创伤患者的回顾性数据收集.
- 分析呼吸支需求,外周氧和和阿片类药物在RA之前和之后的消耗.
主要成果:
- 起器脊柱平面 (ESP) 和前平面 (SAP) 块是最常用的RA技术.
- 在手术后,RA显著降低了呼吸支需求,改善了氧和水平.
- 与RA前水平相比,RA管理后24小时内阿片类药物消费显著减少.
结论:
- 区域麻醉技术在改善呼吸支和减少患有高负荷胸壁创伤的患者的阿片类药物消费方面具有显著的益处.
- 在管理严重的胸壁创伤时,支持使用RA,特别是在立即固定肋骨不可行的情况下.
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