在食道重建中使用双外周导管放置有效的胸腔腹部疼痛管理:一个案例报告
Elizabete Svareniece-Karjaka1, Anna Junga1,2, Aleksandrs Malašonoks3
1Department of Anesthesiology, Riga East Clinical University Hospital, Hipokrata Street 2, LV-1038 Riga, Latvia.
Reports (MDPI)
|November 24, 2025
概括
双外围止痛疗法 (DEA) 在复杂的胸腔腹腔手术中有效地控制了术后疼痛,用于食道重建. 这种阿片类药物节约技术增强了恢复,并在单一导管覆盖不足时减少了阿片类药物的使用.
科学领域:
- 麻醉学 麻醉学
- 手术疼痛管理手术疼痛管理
背景情况:
- 术后疼痛控制在广泛的胸腔腹部手术后至关重要,如食道重建.
- 一个单一的外周导管可能无法充分覆盖手术区域.
- 双外围止痛疗法 (DEA) 提供有针对性的疼痛缓解和减少阿片类药物暴露.
研究的目的:
- 评估DEA在接受食道重建的患者中治疗术后疼痛的疗效和安全性.
- 评估阿片类药物缓解效应和患者康复.
主要方法:
- 一名64岁的男性接受了双重外周导管 (Th5/6和Th11/12) 用于食道重建.
- 术前和术后止痛包括布皮瓦卡因玻尿酸/输液和多模式非阿片类药物IV药物.
- 根据数值评分表 (NRS) 评分,进行了吗啡球注射.
主要成果:
- 在POD1.1上,DEA提供了有效的疼痛控制,平均NRS得分为2 (休息) 和5 (运动).
- 手术后的第二天和第三天显示疼痛得分有所改善 (NRS分别为1/4和3/5).
- 在340小时内消耗的总外周末末末啡是36毫克;24小时的布皮瓦卡因剂量是180毫克.没有出现并发症.
结论:
- 双外周止痛是一种安全和可行的方法,用于复杂的胸腔腹部手术.
- DEA提供有效的阿片类药物节省疼痛管理,支持增强恢复.
- 当单导管外周止痛止痛不够时,这种技术是有益的.
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