Kocher Matthew, Evankovich Maria, Lavage Danielle R, Yilmaz Sabri, Sadhasivam Senthilkumar, Visoiu Mihaela
Department of Anesthesiology and Perioperative Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, 4401 Penn Avenue, Pittsburgh, PA 15224, USA.
Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
Children (Basel). 2024 Mar 20;11(3):368. doi: 10.3390/children11030368.
Vascular anomalies are a diverse group of abnormal blood vessel developments that can occur at birth or shortly afterward. Embolization and sclerotherapy have been utilized as a treatment option for these malformations but may cause moderate-to-severe pain. This study aims to evaluate the utilization of peripheral nerve blocks in opioid consumption, pain scores, and length of stay. A retrospective chart review was conducted at the UPMC Children's Hospital of Pittsburgh for all patients who underwent embolization and sclerotherapy between 2011 and 2020. Patient data were collected to compare opioid consumption, pain scores, and length of stay. In total, 854 procedures were performed on 347 patients. The morphine milligram equivalent per kilogram mean difference between groups was 0.9 (0.86, 0.95) with a -value of <0.001. The pain score mean ratio was -1.17 (-2.2, -0.1) with a -value of 0.027. The length of stay had an incident rate ratio of 0.94 (0.4, 2) and a -value of 0.875. By decreasing opioid consumption and postoperative pain scores, peripheral nerve blocks may have utility in patients undergoing embolization and sclerotherapy while not clinically increasing the length of stay for patients. Their use should be individualized and carefully discussed with the interventional radiologist.
血管异常是一组多样的血管发育异常情况，可在出生时或出生后不久出现。栓塞和硬化疗法已被用作这些畸形的治疗选择，但可能会引起中度至重度疼痛。本研究旨在评估外周神经阻滞在阿片类药物使用量、疼痛评分和住院时间方面的应用。对匹兹堡大学医学中心儿童医院2011年至2020年间接受栓塞和硬化疗法的所有患者进行了回顾性病历审查。收集患者数据以比较阿片类药物使用量、疼痛评分和住院时间。总共对347名患者进行了854例手术。两组之间每千克吗啡毫克当量的平均差异为0.9（0.86，0.95），P值<0.001。疼痛评分平均比值为-1.17（-2.2，-0.1），P值为0.027。住院时间的发生率比值为0.94（0.4，2），P值为0.875。通过减少阿片类药物使用量和术后疼痛评分，外周神经阻滞可能对接受栓塞和硬化疗法的患者有用，同时不会在临床上增加患者的住院时间。其使用应个体化，并与介入放射科医生仔细讨论。
