在镇静下进行的跨腺前列腺活检的局部麻醉:对手术内和术后麻醉剂的使用的影响
Thomas Li1, Taylor M McCready2,3, Sunny Nalavenkata4
1Uro-Oncology Department, Chris O'Brien Lifehouse, Sydney, NSW, Australia.
World journal of urology
|June 21, 2025
概括
在镇静前列腺活检期间使用局部麻醉剂显著减少了手术后的疼痛和麻醉剂的使用. 这一发现表明,布皮瓦卡因在经前列腺活检后改善了患者的治疗结果.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 麻醉学 麻醉学
- 疼痛管理 疼痛管理
背景情况:
- 甲经前列腺活检通常在镇静下进行.
- 对于接受这些手术的患者来说,疼痛和麻醉剂的使用是很大的担忧.
- 优化疼痛控制对于患者的康复和满意度至关重要.
研究的目的:
- 为了评估局部麻醉剂 (布皮瓦卡因) 在缓解镇静性跨关节前列腺活检期间疼痛和其他不良结果的疗效.
- 评估布皮瓦卡因对麻醉后护理单位 (PACU) 疼痛评分,麻醉剂要求,PACU停留时间和尿液保留的影响.
主要方法:
- 在2022年11月至2023年12月期间,在镇静下进行的880次跨关前列腺活检的回顾性分析.
- 患者被分为两组:接受布皮瓦卡因的患者和未接受布皮瓦卡因的患者.
- 统计分析包括多变量逻辑和线性回归,以评估布皮瓦卡因对各种结果的影响.
主要成果:
- 接受布皮瓦卡因治疗的患者报告最大PACU疼痛评分显著降低 (3.0%对9.0%),并且需要更少的麻醉剂 (2.6%对9.3%).
- 布皮瓦卡因使用与减少手术内使用芬太尼有关,但增加了手术内使用普罗波.
- 两组之间没有观察到PACU停留时间或尿液保留的显著差异.
结论:
- 在镇静的跨关节前列腺活检期间给予局部麻醉剂有效地减少了手术后的疼痛和需要麻醉止痛的需要.
- 布皮瓦卡因似乎是改善患者舒适度和减少阿片类药物需求的有益补充剂.
- 建议进行进一步的随机对照试验,以确认这些发现并建立最佳的麻醉方案.
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