胸部手术后进行术后疼痛控制的区域性镇痛:叙述性综述
Sang-Jin Park1, Eun Kyung Choi1
1Department of Anesthesiology and Pain Medicine, Yeungnam University College of Medicine, Daegu, Korea.
Journal of Yeungnam medical science
|December 4, 2025
概括
有效的胸切除术后疼痛管理至关重要. 区域性止痛疗法比阿片类药物更受欢迎,胸部准脊椎阻断 (PVB) 和带平面阻断为最佳患者结果提供不同的风险效益概况.
科学领域:
- 麻醉学 麻醉学
- 疼痛管理 疼痛管理
- 胸部外科手术 胸部外科手术
背景情况:
- 胸切除术后的疼痛需要有效的管理,以预防肺部并发症和慢性疼痛.
- 系统性阿片类药物具有不良影响,使得区域止痛药成为首选的方法.
- 胸腔外围止痛,虽然有效,但携带风险,如低血压和神经事件.
研究的目的:
- 审查和比较各种区域性镇痛技术用于胸切除术后的疼痛.
- 评估不同区域区块的疗效和安全性.
- 根据个体患者和手术因素指导选择最佳疼痛管理策略.
主要方法:
- 关于胸腔切除区域止痛技术的当前文献的综述.
- 胸部外围止痛,胸部准脊椎阻断 (PVB),直立脊柱平面 (ESP) 阻断,交叉过程阻断和其他区域方法的比较.
- 分析安全性,止痛效果,技术要求和故障率.
主要成果:
- 胸部副脊椎阻塞 (PVB) 提供与胸部外周止痛疗法相比的疗效,具有更好的血液动力稳定性,但具有技术挑战和更高的失败率.
- 带平面阻塞,如勃起器脊柱平面 (ESP) 阻塞,更简单,更安全,但可能提供较低的强度止痛.
- 其他技术,如serratus前面平面阻断和肋间神经阻断,通常不足以治疗严重的胸切除术疼痛.
结论:
- 没有一个单一的区域性止痛技术是普遍优越的胸切除术后的疼痛.
- 个性化疼痛管理至关重要,要平衡每种技术的风险-益处概况,以及患者的并发病和手术因素.
- 专业知识和机构资源在选择最佳区域止痛方法方面发挥着作用.
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