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胸部外科手术中关节间平面阻塞的下横过程的止痛效果:一个随机的,受控的,非劣势试验

Wei Wu¹, Yang Liu¹, Meiyun Liu¹

¹Department of Anesthesiology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China.

Journal of clinical anesthesia

|February 16, 2026

概括

横向下过程关节间平面 (STIL) 阻断与胸部副脊椎阻断 (TPVB) 在胸部手术后的术后疼痛管理方面同样有效. 这一发现为这些患者有效控制疼痛提供了新的替代方案.

科学领域:

麻醉学和疼痛管理
胸部外科手术胸部外科手术
区域麻醉技术区域麻醉技术

背景情况:

有限的临床证据表明,胸部外科手术后的下横过程间平面 (STIL) 阻断的止痛效果有限.
胸部副脊椎阻塞 (TPVB) 是胸部手术止痛的常见方法.

研究的目的:

在接受胸部手术的患者中,比较STIL阻断对TPVB的术后止痛疗效.
为了确定STIL阻断是否与TPVB在疼痛控制方面不劣.

主要方法:

一个随机的,非劣势性试验与接受视频辅助胸腔镜手术的患者进行.
患者接受了STIL阻塞或TPVB与标准化局部麻醉剂混合物.
在深呼吸时的疼痛强度被评估使用在手术后48小时内数值评分尺度的曲线下面积 (AUC).

主要成果:

在深呼吸期间的48小时术后疼痛AUC在STIL阻断和TPVB组之间在每条协议和治疗意图分析中都是可比的.
疼痛AUC的平均差异在两个分析群体的预定义非劣势差距内.
在任何治疗组中都没有报告任何严重不良事件.

结论:

在胸部手术后的术后疼痛控制中,横向下过程关节间平面 (STIL) 阻断证明与胸部椎阻断 (TPVB) 不相差.
在接受胸部手术的患者中,STIL阻断是一种可行的和有效的止痛替代品.
进一步的研究可能会探索长期的结果和患者对STIL阻断的满意度.

关键词:

通过神经阻断,阻断神经.副脊椎阻塞副脊椎阻塞手术后的疼痛术后的疼痛区域麻醉地区麻醉胸部外科手术胸部外科手术

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