勃起器脊柱平面阻塞与儿童的尾部阻塞:系统性审查和元分析
Alexa Chedid1, Rawan Masarwa2, Rodrigo Muscogliati3,2
1Medical School, Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos, LBN.
勃起器脊柱平面阻塞 (ESPB) 与尾部外周阻塞 (CEB) 相比,提供了长时间的儿科手术止痛. 然而,类似的救援止痛需要质疑ESPB.
科学领域:
- 麻醉学和疼痛管理
- 儿科手术 儿科手术
- 区域麻醉技术 区域麻醉技术
背景情况:
- 勃起脊柱平面阻塞 (ESPB) 和尾部外周阻塞 (CEB) 是治疗儿科手术疼痛的区域麻醉技术.
- 建立了CEB,而ESPB正在对潜在的更长时间的疼痛缓解产生兴趣.
- 在儿科手术中需要对这些阻塞进行比较的疗效和安全性数据.
研究的目的:
- 系统地审查和元分析ESPB与CEB在儿科手术患者中的疗效和安全性.
- 为了比较这两种技术之间的第一次救援止痛和术后疼痛分数 (FLACC) 的时间.
- 评估和比较与ESPB和CEB相关的不良事件率.
主要方法:
- 对9项涉及612名儿科患者的随机对照试验的系统综述和元分析.
- 主要结局:时间到第一次救援止痛.
- 二级结局:面部,腿部,活动,哭声和安慰度 (FLACC) 疼痛评分和不良事件;随机效应模型由于高异质性.
主要成果:
- 与CEB相比,ESPB显著延长了第一次救援止痛的时间 (SMD = 2.75,p < 0.0001).
- 在24小时后,ESPB显示FLACC得分有所改善 (SMD = 0.25,p = 0.03),而在1小时后,CEB提供了更好的止痛 (SMD = 0.51,p = 0.04).
- 类似比例的患者需要救援止痛 (70%的ESPB与60%的CEB,p = 0.62),并发症率低且可比.
结论:
- ESPB是一种安全有效的CEB替代品,用于儿科手术止痛,提供长时间的疼痛缓解.
- 延长ESPB治疗时间的临床益处受到救援止痛的相似要求的影响.
- 需要进一步的大规模,标准化的研究,以充分定义ESPB在儿科麻醉中的作用.
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