为关节镜肩部手术优化上部干块:低剂量与常规剂量罗皮瓦卡因对麻醉,止痛和腹膜功能的随机双盲比较
Jinxiang Zhang1,2, Yangyang Zhou1, Peng Ding3
1Department of Anesthesiology, Shanghai Changzheng Hospital, the Second Affiliated Hospital of Naval Medical University, 415 Fengyang Road, Shanghai, 200003, China.
BMC anesthesiology
|October 31, 2025
概括
在肩膀手术期间,用低剂量罗皮瓦卡因治疗上部干部阻塞 (STB) 显著降低了半膜 (HDP) 的风险. 虽然它对麻醉有效,但与传统剂量相比,它可能提供较少的术后疼痛缓解.
科学领域:
- 麻醉学 麻醉学
- 区域麻醉地区麻醉
- 肌肉骨手术 肌肉骨手术
背景情况:
- 上层干块 (STB) 是肩膀手术中跨块的替代品.
- STB的目的是减少半膜 (HDP) 的风险.
- 对STB的最佳局部麻醉剂量仍未确定.
研究的目的:
- 在肩膀关节镜检查中评估低剂量罗皮瓦卡因对STB的治疗.
- 评估其在提供外科麻醉方面的有效性.
- 确定其对HDP发生率,安全性和患者舒适性的影响.
主要方法:
- 88名接受肩膀关节镜检查的患者被随机分配.
- 组接受低剂量 (10毫升0.25%罗皮瓦卡因) 或常规剂量 (15毫升0.5%罗皮瓦卡因) 的STB.
- 主要结局:阻断后3小时的HDP发生率;次要结局包括麻醉成功,疼痛和满意度.
主要成果:
- 低剂量的STB显著降低了HDP发生率 (31.8%与84.1%,p < 0.001).
- 两组人都成功地实现了手术麻醉,而没有进行全身麻醉转换.
- 低剂量组的患者满意度更高,但在12小时内疼痛得分也更高,阻塞持续时间更短.
结论:
- 对STB的低剂量罗皮瓦卡因 (10毫升0.25%) 有效地提供了手术麻醉,并显著降低了HDP发生率.
- 这种方案可能会损害术后止痛疗效.
- 需要进一步研究优化剂量以达到平衡的疗效和安全性.
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