在单门视频辅助胸腔镜手术后,肋间间神经阻塞优于勃起脊柱平面阻塞:随机对照试验
Shuo-Ying Dai1, Yen-Chin Liu2, Ting-Wei Kang3
1Division of Thoracic Surgery, Department of Surgery, Yuan's General Hospital, Kaohsiung, Taiwan.
American journal of surgery
|September 6, 2025
概括
胸间神经阻断 (ICNB) 提供了优越的早期疼痛缓解,而不是起脊柱平面阻断 (ESPB) 在VATS切除后. 这两种药物是安全的,并有助于康复,ICNB提供了更好的疼痛管理.
科学领域:
- 胸部手术
- 治疗疼痛
- 区域麻醉
背景情况:
- 单门视频辅助胸腔切除术 (VATS) 需要有效的术后疼痛控制.
- 肋间神经阻断 (ICNB) 和直立脊柱平面阻断 (ESPB) 是用于胸部手术疼痛的区域麻醉技术.
- 在VATS后优化止痛和恢复对于患者的结果至关重要.
研究的目的:
- 通过超声导向的勃起器脊柱平面阻断 (ESPB) 与胸腔间神经阻断 (ICNB) 的止痛效果和安全性进行比较.
- 评估术后疼痛评分,阿片类药物消耗,以及两个阻断组之间的恢复参数.
- 评估与阻断相关的不良事件的发生率.
主要方法:
- 一个双盲,随机对照试验,涉及60名接受选择性单门VATS叶切除术的患者.
- 患者被随机分配为接受ICNB (n=30) 或ESPB (n=30).
- 使用视觉模拟尺度 (VAS) 评估休息和咳期间的术后疼痛,以及阿片类药物消耗和恢复指标.
主要成果:
- 与ESPB组相比,ICNB组在术后4小时和8小时显示出明显较低的休息和咳VAS得分.
- 接受ESPB治疗的患者显著更早地需要吗啡,并且24小时累计消耗量更高,尽管这种差异在统计学上并不显著.
- 在手术后的恶心,吐,并发症,排水时间或住院时间方面没有发现显著差异.
结论:
- 在单门VATS切除术后,ICNB的早期止痛效果优于ESPB.
- ICNB和ESPB都是安全的,并促进单门VATS叶切除术后的快速恢复.
- 在这种患者群体中,ICNB可能是早期术后疼痛治疗的首选方案.
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