外周支柱患者控制的镇痛对腰椎手术后的疼痛缓解的影响 - 一项病例对照研究
Hsin-Chang Chen1,2,3,4, Jin-Huei Yu2,5, Ming-Han Hsieh6
1Department of Orthopedic Surgery, Taipei City Hospital Heping Branch, Taipei, Taiwan.
Journal of orthopaedic surgery (Hong Kong)
|January 7, 2026
概括
腹膜外注患者控制疼痛缓解 (PCA) 显著改善了腰椎手术的老年患者的术后疼痛缓解. 这种方法减少了疼痛评分和止痛药的需求,而不会增加感染风险.
科学领域:
- 神经外科 神经外科
- 麻醉学 麻醉学
- 老年医学 老年医学
背景情况:
- 患有脊髓退行性疾病的老年患者往往有并发症,使术后疼痛管理复杂化.
- 有效的疼痛控制对于恢复和减少这一群体的并发症至关重要.
研究的目的:
- 为了评估外围注射患者控制疼痛缓解 (PCA) 的疗效,以缓解患有退行性疾病的腰椎手术的老年患者的术后疼痛.
- 为了比较疼痛评分,止痛药消耗和外周PCA和标准疼痛管理之间的并发症.
主要方法:
- 追溯病例控制研究涉及209名接受腰椎手术的老年患者 (平均年龄73.8岁).
- 患者接受了72小时的外周PCA或标准的术后疼痛管理.
- 主要终点:术后1-3天的视觉模拟量 (VAS) 平均得分. 二次终点包括救援止痛药,吗啡消耗,排水和并发症.
主要成果:
- 外周注射PCA组显示,与对照组相比,从术后1-3天的VAS平均得分明显较低 (p < 0.001).
- 在PCA组的患者需要显著减少救援止痛注射和减少总吗啡.
- 虽然PCA组的排水量和持续时间更高,但感染率和住院时间长度相似.
结论:
- 腹膜PCA是一种有效的方法,用于管理经手术后的疼痛,在接受腰椎手术的老年患者具有并发症.
- 这种方法提供了卓越的缓解疼痛,并减少了止痛药的需求,而不会显著增加感染率.
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