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偏胃神经阻塞有效地控制了初级 laparoscopic袖子胃切除术后的内脏疼痛

Dongwon Lim¹, Yoona Chung¹, Bomina Paik¹

¹Department of Surgery, H+ Yangji Hospital, Seoul, Korea, Republic of.

Obesity surgery

|June 16, 2025

概括

腹腔神经阻塞 (PGNB) 在腹腔镜袖子胃切除术 (LSG) 后显著降低了早期术后内脏疼痛和镇痛需求. 这种技术提供了有效的疼痛管理,没有重大并发症,改善了患者的康复.

科学领域:

麻醉学麻醉学
手术疼痛管理手术疼痛管理
胃肠道手术胃肠道手术

背景情况:

手术后增强恢复 (ERAS) 协议改善了外科手术期间的护理,但内脏疼痛 (VP) 仍然具有挑战性.
标准的多模式止痛药 (MMA) 往往不能充分控制早期的手术后风险性肌痛.
准胃神经阻塞 (PGNB) 被探索为针对VP的有针对性的干预.

研究的目的:

为了评估PGNB在治疗腹腔镜袖子胃切除术 (LSG) 后早期术后内脏疼痛方面的有效性.
为了比较接受标准MMA和接受PGNB加MMA的患者之间的疼痛强度和止痛要求.
评估二次结果,包括缓解疼痛的时间,缓解疼痛的消耗,以及恶心/吐的发生率.

主要方法:

一项回顾性研究比较了50名接受标准MMA (包括TAP阻塞) 的患者和50名接受PGNB加MMA的患者.
主要结局是手术后48小时内用数值评分表 (NRS) 测量疼痛强度.
二次结局包括第一次止痛剂的时间,累积止痛剂剂量,恶心/吐和血液动力学.

主要成果:

在术后8小时内,PGNB组的NRS得分明显较低 (p<0.001).
在PGNB组中,第一次救援止痛药的时间延长了 (1084分 vs 260分;p<0.001),止痛药的使用减少了.
在PGNB组中,手术时间较长 (113.9分 vs 97.8分;p<0.001);发生了一个局部性血液瘤,没有其他并发症.

结论:

PGNB有效地减少了内脏疼痛,并在LSG后的早期术后期需要救援止痛药.
该技术与第一次止痛药的时间延长和整体止痛药消耗的减少有关.
PGNB表现出良好的安全性,没有发现重大并发症.

关键词:

帕拉胃神经阻塞手术后的恶心和吐.手术后的疼痛控制袖子胃切除术是什么意思内疼痛是一种内疼痛.

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