两种外围区域止痛技术的比较,用于初级选择性关节整形术:一个随机临床试验
Francesca Buffoli1, Claudia Bonetti2, Camilla Pugno2
1Department of Anesthesia and ICU, Mellino Mellini Hospital, Chiari, Italy.
Anaesthesia
|July 21, 2025
概括
对于全关节整形术,前部 (囊神经群和侧肌神经) 块和后部 (起器脊柱平面) 块都提供类似的疼痛缓解和运动功能. 两种阻断都没有在减少术后吗啡使用或疼痛得分方面显示出显著的优势.
科学领域:
- 麻醉学 麻醉学
- 整形外科手术 整形外科手术
- 疼痛管理 疼痛管理
背景情况:
- 区域麻醉技术对于在全关节整形手术中进行术前疼痛管理至关重要.
- 勃起器脊柱平面,周囊神经群和侧肌神经块提供运动节约性止痛,但针对不同的区域.
- 将这些阻塞进行比较对于优化疼痛控制和功能恢复至关重要.
研究的目的:
- 为了比较周囊神经组 (PENG) 阻断与侧肌神经 (LFCN) 阻断相结合的疗效,与直立脊柱平面 (ESP) 阻断相比.
- 为了评估术后止痛和运动障碍后的整体关节整形手术.
- 确定部手术患者的最佳区域止痛技术.
主要方法:
- 一项随机研究涉及接受初级选择性单边全关节整形手术的患者.
- 患者接受了脊髓麻醉和多模式止痛.
- "前面"块组 (PENG + LFCN) 与"后面"块组 (ESP) 的比较.
主要成果:
- 前部和后部阻断组之间24小时静脉注射吗啡消费没有显著差异 (p > 0.99).
- 前部组 (1/31) 与后部组 (5/31) 的较低运动阻塞发生率趋势,尽管在统计学上不显著 (p = 0.09).
- 在二次结果中没有发现显著差异,包括疼痛得分和并发症率.
结论:
- 在前后运动节约区域止痛技术之间没有发现统计或临床显著的差异,用于全关节整形术.
- 区块的选择可能取决于情况,受患者和系统因素的影响.
- 这两种技术都是关节置换手术中多模式止痛的可行选择.
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