勃起器脊柱平面阻塞与单门视频镜辅助胸部手术中的肋间间神经阻塞:一个多中心,双盲,前性随机的安慰剂受控试验
S Coppens1,2, D F Hoogma1,2, G Dewinter1,2
1Consultant, Department of Anesthesiology, University Hospitals of Leuven, Herestraat 49, B-3000, Leuven, Belgium.
Anesthesiology
|June 19, 2025
概括
与勃起器脊柱平面块相比,直接应用的间肋间神经块在单门胸腔镜手术后提供更好的疼痛缓解. 这种手术方法减少了吗啡消耗和全身局部麻醉剂的吸收,增强了患者的康复.
科学领域:
- 胸部外科手术 胸部外科手术
- 疼痛管理 疼痛管理
- 麻醉学 麻醉学
背景情况:
- 由于局部麻醉剂吸收问题,皮间神经阻塞 (ICB) 需要谨慎使用.
- 勃起器脊柱平面 (ESP) 块在胸部手术中受到广泛覆盖的青.
- 在单门胸腔镜手术中,直接可视化的ICB可能比ESP阻断提供更好的止痛.
研究的目的:
- 为了比较直接手术ICB与超声波引导ESP阻断对止痛的疗效.
- 为了评估手术后的吗啡消耗和疼痛评分.
- 评估并发症和全身局部麻醉剂的吸收.
主要方法:
- 多中心,双盲,安慰剂控制,随机化试验.
- 100名接受单门胸腔镜手术的患者接受了ICB或ESP阻塞,用罗皮瓦卡因或盐水.
- 主要结局:12个小时的吗啡消费后输出管.
主要成果:
- 在ICB组,12小时 (10.9毫克与17.6毫克) 和24小时 (18.7毫克与26.7毫克) 的吗啡消费量显著降低.
- 在ICB组中,术后疼痛得分较低,救援止痛需要减少 (16%vs. 40%).
- 在ESP阻断组中观察到局部麻醉剂的更高的全身吸收.
结论:
- 与ESP块相比,直接手术ICB在单门胸腔镜手术中提供了更好的止痛效果.
- ICB显著降低了阿片类药物需求和全身麻醉剂暴露.
- 没有注意到患者满意度,并发症或住院时间的显著差异.
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