时间很重要:一项随机对照试验比较了手术前和手术后的勃起器脊柱平面阻塞,用于 laparoscopic 胆囊切除术中的止痛
Mehmet Sait Acar1, Veli Fahri Pehlivan2, Basak Pehlivan2
1Department of Anesthesia and Reanimation, Ministry of Health, Akçakale State Hospital, 63200 Sanliurfa, Türkiye.
Medicina (Kaunas, Lithuania)
|October 29, 2025
概括
手术前的勃起器脊柱平面块 (ESPB) 提供了与腹腔镜胆囊切除术后的ESPB可比的疼痛缓解. 然而,手术前的ESPB改善了手术内血动力学稳定性和手术方便性.
科学领域:
- 区域麻醉地区麻醉
- 疼痛管理 疼痛管理
- 手术手术手术手术手术手术手术手术手术手术
背景情况:
- 勃起器脊柱平面阻塞 (ESPB) 是一种新兴的区域麻醉技术,用于术后缓解疼痛.
- 腹腔镜胆囊切除术 (LC) 的ESPB (手术前和术后) 的最佳时间尚不清楚,这会影响血液动力学稳定性和可行性.
研究的目的:
- 在选择性LC患者中,比较手术前和术后ESPB的止痛效果,手术内血动力学和程序优势.
主要方法:
- 一个前性,随机的,单盲试验,涉及80名接受选择性LC的成年患者.
- 患者接受双边ESPB,无论是预麻醉诱导 (第一组) 或术后在输出管之前 (第二组).
- 主要结局:2小时后的术后疼痛 (数值评分表);次要结局包括血液动力学,救援止痛和满意度.
主要成果:
- 两组患者均表现出显著的术后疼痛减轻,疼痛强度和特拉马多尔消费量相似.
- 手术前的ESPB组表现出明显更稳定的手术内血压.
- 没有观察到与ESPB相关的并发症;患者满意度在各组之间是相似的.
结论:
- 术前和术后的ESPB为LC提供了类似的止痛和阿片类药物缓解效果.
- 手术前的ESPB增强了手术期间的血液动力学稳定性,并简化了块的管理.
- 手术前的ESPB可能有利于在微创胆道手术中增强手术后恢复 (ERAS) 协议.
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