皮穿性神经利息切除术后的外周神经阻塞镇痛:一个系统的审查和网络元分析
Fei Deng, Ting Li, Huijuan Chen
1- rdqing30@qq.com.
Minerva anestesiologica
|October 8, 2025
概括
皮肤间神经阻断 (ICNB) 提供了皮肤穿神经切除术 (PCNL) 后最好的疼痛缓解. 这种方法显著减少了吗啡的使用,并改善了患者的舒适性,与其他外围神经阻塞 (PNBs) 相比.
科学领域:
- 麻醉学 麻醉学
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 疼痛管理 疼痛管理
背景情况:
- 穿皮石切除术 (PCNL) 是一种常见的石切除手术.
- 有效的术后疼痛管理对于患者的康复和减少并发症至关重要.
- 外围神经阻塞 (PNBs) 越来越多地被认为是它们在管理PCNL相关疼痛方面的潜力.
研究的目的:
- 进行系统审查和网络元分析 (NMA).
- 评估和比较各种PNBs在PCNL后术后止痛的疗效.
主要方法:
- 在主要数据库中进行了全面的文献搜索,截至2025年4月.
- 包括随机对照试验 (RCT),比较不同的PNB或PNB与没有区块.
- 主要结局是手术后24小时的吗啡消耗;使用Stata 15.1.1.进行NMA.
主要成果:
- 38个带有2,339名患者的RCT评估了7种止痛技术.
- 肋间间神经阻塞 (ICNB) 在吗啡消耗和VAS得分中显示出最大的降低.
- 此外,ICNB还减少了术后恶心和吐 (PONV),并延长了第一次救援止痛的时间.
结论:
- 肋间神经阻断 (ICNB) 似乎是PCNL后术后止痛的最佳技术.
- 其他有效的技术包括周管透 (PI) 和直立脊柱平面阻塞 (ESPB).
- 发现横腹部平面阻断 (TAPB) 的效果较低.
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