编程间歇性玻尿酸与持续输液用于胸腔镜手术后区域性止痛:系统性审查和元分析
Dongqing Ren1, Zhilong Liu1, Yanjun Gao1
1Department of Anesthesiology, Gansu Provincial Hospital, Lanzhou, Gansu, People's Republic of China.
Journal of pain research
|August 19, 2025
概括
编程间歇性玻尿液输注 (PIBI) 提供较低的局部麻醉使用和更广泛的感觉阻塞比连续输注 (CI) 胸腔镜手术疼痛. 然而,两种区域性止痛方法之间没有观察到疼痛评分和阿片类药物使用的显著差异.
科学领域:
- 麻醉学和疼痛管理
- 胸部外科手术 胸部外科手术
- 药理学 药理学是指药理学的学科.
背景情况:
- 持续的区域性止痛疗法最好用于术后疼痛管理.
- 胸腔镜手术中区域止痛的最佳输液模式仍在争论中.
- 编程间歇性玻尿液输注 (PIBI) 和连续输注 (CI) 是关键的方法.
研究的目的:
- 系统地审查和元分析随机对照试验 (RCT).
- 为了比较PIBI与CI在胸腔镜外科手术中的区域性镇痛的临床疗效.
- 为了评估疼痛评分,阿片类药物消耗和局部麻醉剂使用的差异.
主要方法:
- 搜索的主要数据库 (PubMed,Embase,科学网,科克兰图书馆) 截至2025年3月.
- 包括7个RCT,涉及394名患者,比较PIBI和CI的区域止痛.
- 使用ReMan 5.4软件进行了元分析.
主要成果:
- 在休息视觉模拟尺度 (VAS) 6小时没有显著差异.
- 在12小时后,PIBI显示了降低休息和运动VAS的潜力,并降低了最初24小时的吗啡消耗.
- 与CI相比,PIBI表明局部麻醉剂消耗较低,感官阻塞范围更广.
结论:
- 在胸腔镜手术中,PIBI在局部麻醉剂消耗和感官阻塞程度方面具有优势.
- 在PIBI和CI之间,在术后疼痛得分或整体阿片类药物消费方面没有发现显著的临床差异.
- 研究的局限性包括异质性,专注于肺部手术,缺乏长期慢性疼痛数据.
相关概念视频
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
560
Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
One of the advantages of...
560
Local Anesthetics: Clinical Application as Epidural Anesthesia
498
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
498
Local Anesthetics: Clinical Application as Spinal Anesthesia
777
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
777
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
171
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
171
Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia
1.2K
Depending on the target organ, local anesthetics (LAs) can be administered via various routes. In surface anesthesia, LAs are applied directly to the surface of the skin or mucous membranes. It is widely used for topical skin numbing before venipuncture or minor surgical procedures. Commonly used surface local anesthetics are lidocaine or benzocaine sprays or creams. Surface anesthesia occurs within 5 minutes and lasts for about 60 minutes. One of the main disadvantages of topical anesthesia is...
1.2K
General Anesthesia: Overview
283
Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
283


