在患有长QT综合征和Catecholaminergic Polymorphic Ventricular Tachycardia的儿童中优化术后疼痛管理,经历左心交感性肌:连续勃起器脊柱平面阻塞和状平面阻塞的病例系列
V Mossetti1, R Di Corrado1, H HaxhiNasto1
1Anesthesia and Intensive Care, Regina Margherita Children Hospital, Città Della Salute e Della Scienza, Turin, Italy.
Paediatric anaesthesia
|November 6, 2025
概括
使用联合区域麻醉 (直立脊柱平面和塞拉特平面块) 的多式疼痛管理策略有效地减少了为长QT综合征和CPVT接受VATS-LCSD的儿科患者的术后疼痛和阿片类药物需求.
科学领域:
- 心脏病学 心脏病学
- 麻醉学 麻醉学
- 儿科手术 儿科手术
背景情况:
- 遗传性长QT综合征 (LQTS) 和神经质多形心室高心率 (CPVT) 是遗传性心律失常性疾病,增加心律失常风险.
- 通过视频辅助胸腔镜手术 (VATS) 进行左心交感缩 (LCSD) 是药物耐药病例的关键治疗方法.
- 在这些儿科患者中,术后疼痛管理是一个重大挑战.
研究的目的:
- 评估使用联合区域麻醉的多式外科手术周围疼痛管理方法.
- 评估其对术后疼痛评分,阿片类药物需求和神经病痛发病率的影响.
- 专注于接受LQTS和CPVT的VATS-LCSD的儿科患者.
主要方法:
- 对接受VATS-LCSD (2021年至2025年3月) 的儿科患者的回顾性分析.
- 所有患者都接受了直立脊柱平面 (ESP) 和塞拉图斯平面 (SP) 块.
- 在ESP阻塞后,通过外周导管进行持续局部麻醉输液.
主要成果:
- 包括15名患有LQTS或CPVT的儿科患者 (平均年龄6.9岁).
- 没有重大并发症;一次意外的ESP导管切除.
- 所有患者报告的VAS疼痛分数低于2,没有额外的阿片类药物或凯托洛拉克使用,也没有神经病变性疼痛.
结论:
- 联合区域麻醉 (ESP和SP块) 是有效的术后疼痛管理在儿科通道病患者接受VATS-LCSD.
- 这种多式联络方式可能会提高这种弱势群体的护理质量.
- 支持使用区域麻醉方案以改善结果.
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