周围神经甲松有效地延长了全关节整形术中的麻醉阻断时间,减少了阿片类药物消耗,并且不会损害运动功能,神经完整性或血糖控制
Tomasz Reysner1, Grzegorz Kowalski2, Aleksander Mularski3
1Poznan University of Medical Sciences, Poznań, Poland. treysner@ump.edu.pl.
International orthopaedics
|June 11, 2025
概括
在周囊神经组 (PENG) 块中添加周围神经甲松可显著延长经历关节整形手术 (THA) 的老年患者的疼痛缓解时间. 这种组合可以减少阿片类药物的使用,而不会影响运动功能或神经安全.
科学领域:
- 麻醉学 麻醉学
- 整形外科手术 整形外科手术
- 老年医学 老年医学
背景情况:
- 在整部关节整形术 (THA) 后,有效的术后疼痛管理对于老年患者至关重要.
- 周囊神经群 (PENG) 阻断提供了疼痛缓解,并保留了运动功能,但持续时间有限.
- 需要添加剂来延长PENG阻断剂在这个人群中的止痛作用.
研究的目的:
- 评估周围神经甲松在延长PENG阻断止痛的持续时间方面的疗效.
- 评估周围神经甲松对老年THA患者阿片类药物消耗和疼痛评分的影响.
- 确定周围神经甲松在运动功能,神经完整性和血糖控制方面的安全性.
主要方法:
- 一个双盲,随机对照试验,涉及60名老年患者 (≥65岁) 接受THA.
- 患者接受了与罗皮瓦卡因的PENG阻断剂或与罗皮瓦卡因加上围甲的PENG阻断剂.
- 主要结局:时间到首次救援阿片类药物;次要结局:阿片类药物消费,疼痛得分,四头肌强度和48小时内的不良影响.
主要成果:
- 围神经德克萨米他显著延长了镇痛时间 (16.0 ± 1.3 vs 9.0 ± 1.7 小时,p < 0.0001).
- 德克萨米他组显示了减少的阿片类药物消耗 (0.9 ± 1.2 vs. 2.1 ± 1.4 mEQ,p = 0.0003) 和较低的疼痛分数在6,12和24小时.
- 四肢骨强度,神经完整性和血糖水平在两组中都没有受到影响.
结论:
- 周围神经甲松有效延长老年THA患者的PENG阻断止痛.
- 这种补充剂显著减少了术后阿片类药物需求.
- 它为增强疼痛管理提供了一种安全的策略,而不会损害运动功能或引起不良影响.
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