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头皮神经阻滞联合肋间神经阻滞对帕金森病患者脑深部电刺激术后恢复质量的影响:一项随机对照试验方案

Effect of Scalp Nerve Block Combined with Intercostal Nerve Block on the Quality of Recovery in Patients with Parkinson's Disease after Deep Brain Stimulation: Protocol for a Randomized Controlled Trial.

作者信息

Sheng Ying, Wang Hui, Chang Xinning, Jin Peipei, Lin Shengwei, Qian Shuang, Xie Jian, Lu Wenbin, Yu Xiya

机构信息

Faculty of Anesthesiology, Changhai Hospital, Naval Medical University/Second Military Medical University, PLA, Shanghai 200433, China.

Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai 200434, China.

出版信息

Brain Sci. 2022 Jul 29;12(8):1007. doi: 10.3390/brainsci12081007.

Abstract

BACKGROUND

Parkinson's disease (PD) patients who receive deep brain stimulation (DBS) have a higher risk of postoperative pain, which will affect their postoperative quality of recovery (QoR). Scalp nerve block (SNB) and intercostal nerve block (ICNB) can alleviate postoperative pain, yet their effect on postoperative QoR in PD patients has proven to be unclear. Therefore, we have aimed to explore the effect of SNB paired with ICNB on postoperative QoR.

METHODS

To explore the effect, we have designed a randomized controlled trial in which 88 patients with PD will be randomly assigned to either an SNB group or control group, receiving either SNB combined with ICNB or without before surgery. The primary outcome will be a 15-item QoR score at 24 h after surgery. The secondary outcomes will include: 15-item QoR scores at 72 h and 1 month after surgery; the numeric rating scale pain scores before discharge from the postanesthesia care unit (PACU) at 24 h, 72 h, and 1 month after surgery; rescue analgesics; nausea and vomiting 24 h after operation and remifentanil consumption during operation; emergence agitation; the duration of anesthesia and surgery; time to respiratory recovery, time to response, and time to extubation; the PACU length of stay; as well as adverse events. Proposed protocol and conclusion: Our findings will provide a novel method for the management of recovery and acute pain after DBS in PD patients. This research was registered at clinicaltrials.gov NCT05353764 on 19 April 2022.

摘要

背景

接受脑深部电刺激(DBS)的帕金森病(PD)患者术后疼痛风险较高,这会影响其术后恢复质量(QoR)。头皮神经阻滞(SNB)和肋间神经阻滞(ICNB)可减轻术后疼痛,但其对PD患者术后QoR的影响尚不清楚。因此,我们旨在探讨SNB联合ICNB对术后QoR的影响。

方法

为探讨其效果,我们设计了一项随机对照试验,将88例PD患者随机分为SNB组或对照组,分别在手术前接受SNB联合ICNB或不接受该联合阻滞。主要结局指标为术后24小时的15项QoR评分。次要结局指标包括:术后72小时和1个月的15项QoR评分;术后24小时、72小时和1个月从麻醉后护理单元(PACU)出院前的数字评定量表疼痛评分;解救镇痛药;术后24小时的恶心和呕吐情况以及术中瑞芬太尼用量;苏醒期躁动;麻醉和手术持续时间;呼吸恢复时间、反应时间和拔管时间;PACU住院时间;以及不良事件。拟定方案和结论:我们的研究结果将为PD患者DBS术后恢复和急性疼痛的管理提供一种新方法。本研究于2022年4月19日在clinicaltrials.gov上注册,注册号为NCT05353764。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d83/9405761/671df6c35df4/brainsci-12-01007-g001.jpg

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