深层副侧侧侧肋间平面块及其在心脏快速跟踪程序中的作用
Amir Zabida1, Karen Foley1, Cristopher Araya Gonzalez1
1Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Canada.
Journal of cardiothoracic and vascular anesthesia
|June 10, 2025
概括
深部副间肋间平面 (DPIP) 阻塞减少了阿片类药物的使用,并在心脏手术患者中加快了输出管. 需要进一步的研究来缓解手术后妄想,尽管DPIP阻断的好处.
科学领域:
- 麻醉学和重症监护医学
- 胸部外科手术 胸部外科手术
- 疼痛管理 疼痛管理
背景情况:
- 心脏外科手术后的术后疼痛管理通常依赖于阿片类药物,这可能导致像妄想这样的不良影响.
- 深侧侧侧肋间平面 (DPIP) 块提供一种区域麻醉方法,可以减轻与阿片类药物相关的并发症.
研究的目的:
- 评估DPIP阻断和心脏手术后减少阿片类药物消费之间的关联.
- 评估DPIP阻断对手术后狂妄症发生率的影响.
主要方法:
- 一项回顾性观察性研究,涉及308名接受心脏手术的成年患者,其中中间部分是宫切除术.
- 患者在超声指导下接受DPIP阻塞或标准护理 (对照组).
- 在不同组之间比较了阿片类药物消费,妄发病率和输出管的时间.
主要成果:
- DPIP阻断与手术后12小时和24小时显著降低摩的消耗有关.
- 接受DPIP阻塞的患者早些时候经历了气管外抽 (p=0.04).
- 两组之间没有观察到术后妄想发病率或重大发病率/死亡率的显著差异.
结论:
- DPIP阻塞与手术前期阿片类药物需求的降低和心脏手术后更快的输出有关.
- DPIP块显示了将其整合到快速心脏麻醉方案中的潜力.
- 替代策略是必要的,以有效地减少手术后痴呆症在这个患者群体.
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