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评价一种精准的术中罗哌卡因神经阻滞方法,以改善 120 例行甲状腺手术患者的术后镇痛效果。

Evaluation of a Precision Approach to Intraoperative Ropivacaine Nerve Block to Improve Postoperative Analgesia in 120 Patients Undergoing Thyroid Surgery.

机构信息

Department of General Surgery, Ruijin Hospital Lu Wan Branch, Shanghai Jiaotong University School of Medicine, Shanghai, China (mainland).

Department of Anesthesiology, Ruijin Hospital Lu Wan Branch, Shanghai Jiaotong University School of Medicine, Shanghai, China (mainland).

出版信息

Med Sci Monit. 2022 Apr 29;28:e935563. doi: 10.12659/MSM.935563.

Abstract

BACKGROUND This study aimed to compare a precision approach to intraoperative nerve block with traditional analgesia to reduce postoperative pain in 120 patients during thyroid surgery. The precision intraoperative technique used 0.3% ropivacaine to block the lower branch of the transverse cervical nerve and the inner branches of the supraclavicular nerve. MATERIAL AND METHODS A total of 120 patients were prospectively enrolled in this study. All patients were randomly and evenly divided into 3 groups. In the precision group, 0.3% ropivacaine was used through the wound during surgery. In the traditional group, a superficial cervical plexus nerve block was performed before surgery. Saline was injected in the control group. The valuation of postoperative pain was assessed using the visual analogue scale (VAS). RESULTS Two hours after surgery, the VAS scores in the precision group, traditional group, and control group were 1.4±0.5, 1.6±0.7, and 2.8±1.0 (P<0.001), respectively. Then, the pain improvement was more significant after 6 h, as the VAS scores in the precision, traditional, and control groups were 1.0±0.5, 1.2±0.6, and 2.6±1.1 (P<0.001), respectively. Twenty-four hours after surgery, the VAS scores in the precision, traditional, and control groups were 0.7±0.3, 0.6±0.4, and 1.9±1.1 (P<0.001), respectively. CONCLUSIONS At a single center, the use of a precision intraoperative ropivacaine nerve block significantly reduced postoperative pain when compared with traditional analgesia for patients undergoing thyroid surgery.

摘要

背景

本研究旨在比较术中精准神经阻滞与传统镇痛在 120 例甲状腺手术患者中的应用,以减轻术后疼痛。术中精准技术使用 0.3%罗哌卡因阻滞颈横神经下段和锁骨上神经内侧支。

材料和方法

本研究共纳入 120 例患者,前瞻性随机分为 3 组。在精准组,术中通过切口给予 0.3%罗哌卡因。在传统组,术前行颈浅丛神经阻滞。对照组给予生理盐水。采用视觉模拟评分(VAS)评估术后疼痛程度。

结果

术后 2 小时,精准组、传统组和对照组的 VAS 评分分别为 1.4±0.5、1.6±0.7 和 2.8±1.0(P<0.001)。6 小时后疼痛改善更明显,精准组、传统组和对照组的 VAS 评分分别为 1.0±0.5、1.2±0.6 和 2.6±1.1(P<0.001)。术后 24 小时,精准组、传统组和对照组的 VAS 评分分别为 0.7±0.3、0.6±0.4 和 1.9±1.1(P<0.001)。

结论

在单中心研究中,与传统镇痛相比,术中应用精准罗哌卡因神经阻滞可显著减轻甲状腺手术患者的术后疼痛。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e408/9063454/38b196008b40/medscimonit-28-e935563-g001.jpg

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