直肠外套阻塞对抗局部透止痛的止痛效果在拉巴洛斯科普袖子胃切除术中:一项随机对照试验
Artid Samerchua1, Kanokkan Tepmalai2, Bandhuphat Chakrabandhu2
1Department of Anesthesiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Obesity surgery
|December 4, 2025
概括
腹腔镜外套胃切除术 (LSG) 后的直肠膜阻塞 (RSB) 提供了比局部透止痛 (LIA) 更好的疼痛控制. RSB减少了手术内阿片类药物的使用和早期术后疼痛,支持其用于LSG的多模式止痛.
科学领域:
- 麻醉学 麻醉学
- 手术疼痛管理手术疼痛管理
- 腹部外科 腹部外科
背景情况:
- 直肠膜阻塞 (RSB) 是一种针对腹壁的区域麻醉技术.
- 腹腔镜袖胃切除术 (LSG) 是一种常见的减肥手术,需要有效的术后疼痛管理.
- 将RSB与局部透镇痛 (LIA) 进行比较对于优化LSG后的疼痛控制至关重要.
研究的目的:
- 在接受LSG的患者中,比较RSB与LIA的疗效.
- 为了确定RSB是否与LIA相比提供更好的疼痛缓解.
- 为了评估手术期间的阿片类药物消费和术后的疼痛评分.
主要方法:
- 一项随机对照试验,涉及接受LSG的患者.
- 患者接受了超声导向RSB或LIA.
- 主要结局:手术内使用芬太尼. 二级结局:术后疼痛评分 (NRS),吗啡消耗和恢复指标.
主要成果:
- 与LIA相比,RSB显著降低了手术内芬太尼的消耗.
- 在早期的术后期,RSB在休息和运动期间表现出较低的疼痛分数.
- 接受RSB治疗的患者中较少的患者在手术后报告中度至严重的疼痛.
- 手术后的吗啡使用和恢复指标在各组之间是相似的.
结论:
- 切口前RSB有效地减少了手术内阿片类药物需求.
- 与LSG的LIA相比,RSB提供了优越的早期术后止痛.
- 应将RSB视为LSG多模式止痛策略的一部分.
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