在关节镜肩部外科手术中进行间层阻断与周囊神经阻断和表面椎阻断
Amr Arafa Elbadry1, Marwa A Abogabal1, Laila Elahwal1
1Anesthesiology, Surgical Intensive Care and Pain Medicine Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
Anesthesiology and pain medicine
|January 1, 2026
概括
一种用于关节镜肩部手术 (ASS) 的新型阻塞组合提供了与间臂阻塞 (ISB) 相似的缓解疼痛,但显著减少了半膜性 (DP). 这种方法是一种更安全的替代方案,特别是对于呼吸系统问题患者.
科学领域:
- 麻醉学 麻醉学
- 区域麻醉 区域麻醉
- 疼痛管理 疼痛管理
背景情况:
- 跨层臂阻塞 (ISB) 是关节镜肩部手术 (ASS) 止痛的标准.
- ISB与更高的半膜 (DP) 风险有关.
研究的目的:
- 为了比较超声导向ISB的止痛效果和DP发生率与超声导向周囊神经阻塞 (USG-PENB) 和 ASS表面交阻塞 (SCPB) 的组合.
- 为了评估疼痛评分,阿片类药物消耗,肺功能和患者满意度.
主要方法:
- 一项前性,三盲随机试验,涉及42名接受ASS治疗的患者.
- 患者在全身麻醉后接受了ISB (A组) 或PENB和SCPB (B组) 组合在超声指导下.
- 主要结局是PD发生率;次要结局包括疼痛,阿片类药物使用和肺功能.
主要成果:
- PENB + SCPB 组表现出延迟需要救援止痛 (13.24 小时 vs 8.38 小时) 和较低的 24 小时芬太尼消费 (135.71 vs 192.86 mcg).
- 肺功能更好地保持,在PENB + SCPB组中,DP发生率显著降低 (4.76%对38.1%).
- 在PENB + SCPB组中,在6,12和18小时观察到较低的疼痛得分.
结论:
- 对于ASS,PENB和SCPB的组合提供了与ISB相比的非劣质止痛.
- 这种组合显著降低了PD发生率和阿片类药物需求,为呼吸系统问题患者提供了更安全的替代方案.
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