横向腹部平面阻塞与腹腔外围止痛术的腹腔外科手术:对ERAS协议的含义. 一个系统的审查和元分析
Maria L Garo1, Alessandro Ruggiero2, Marta DI Folco1,3
1Research Unit of Anesthesia and Intensive Care, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy.
Minerva anestesiologica
|December 2, 2025
概括
横向腹部平面块为腹腔镜手术患者提供与胸部外周止痛疗法相比较的疼痛控制. 然而,这种阻断显著加快了功能恢复,包括更早的动员和第一个浮气体.
科学领域:
- 麻醉学和外科康复.
- 疼痛管理策略 疼痛管理策略
- 最少侵入性的外科手术结果.
背景情况:
- 在腹腔镜手术后的康复中,术后止痛非常重要.
- 胸部外周止痛疗法是有效的,但有副作用.
- 横向腹部平面块是一个潜在的替代方案.
研究的目的:
- 系统地比较横向腹部平面块与胸部外周止痛疗法用于术后疼痛控制.
- 评估功能结果和住院时间.
- 通过元分析综合现有证据.
主要方法:
- 按照PRISMA指南进行系统审查和元分析.
- 包括随机对照试验 (RCT),比较腹腔镜外科手术中的两个块.
- 分析的主要结局:24小时后静态疼痛;二次结局:疼痛评分,阿片类药物消耗,功能恢复指标和停留时间.
主要成果:
- 在24小时内,疼痛控制 (科恩d=-0.12) 或阿片类药物消费 (科恩d=-0.09) 没有显著差异.
- 横向腹部平面块显示出明显更快的时间到第一个浮 (科恩的d=-0.61) 和动员 (科恩的d=-0.76).
- 住院时间没有显著差异 (科恩d=-0.14).
结论:
- 横向腹部平面块提供有效的止痛和优越的功能恢复与胸部外周止痛相比.
- 它代表了在腹腔镜外科手术中优化术后恢复协议的可行替代方案.
- 需要进一步进行高质量的研究,以建立标准化指南.
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