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三级医疗医院新生儿硬膜外镇痛的实施与优化：技术报告

The Implementation and Optimization of Neonatal Epidural Analgesia in a Tertiary Care Hospital: A Technical Report.

作者信息

Hudson Timothy, Saev Svetoslav M, Saev Mary, Nadernejad Claudia

机构信息

Pediatric Anesthesiology, Helen DeVos Children's Hospital, Grand Rapids, USA.

Internal Medicine, Trinity Health Muskegon, Grand Rapids, USA.

出版信息

Cureus. 2024 May 20;16(5):e60657. doi: 10.7759/cureus.60657. eCollection 2024 May.

DOI:10.7759/cureus.60657
PMID:38899232
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11186216/
Abstract

Effective analgesic therapy in neonates continues to be fundamental for improving quality of life and decreasing the need for further medical intervention. When pain is not well controlled in the neonatal intensive care setting, we see an increased use of sedation pharmaceuticals, mechanical ventilation, and altered somatosensory development, among other complications. Currently, there is no standardized protocol addressing effective pain management while decreasing the need for further sedation. In this article, we seek to demonstrate how our institution standardized and implemented the utilization of epidural analgesia in neonates as the preferred method of pain management for open thoracic and abdominal surgeries.

摘要

有效的新生儿镇痛治疗对于改善生活质量和减少进一步医疗干预的需求仍然至关重要。在新生儿重症监护环境中，如果疼痛控制不佳，我们会看到镇静药物、机械通气的使用增加，以及体感发育改变等其他并发症。目前，尚无标准化方案可在减少进一步镇静需求的同时实现有效的疼痛管理。在本文中，我们试图展示我们的机构如何将新生儿硬膜外镇痛的使用标准化并加以实施，将其作为开胸和腹部手术首选的疼痛管理方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/73e7/11186216/f317b40079fe/cureus-0016-00000060657-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/73e7/11186216/1393c36b1171/cureus-0016-00000060657-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/73e7/11186216/472ac6999fb4/cureus-0016-00000060657-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/73e7/11186216/0b9ad8a737e4/cureus-0016-00000060657-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/73e7/11186216/94ad9c20f9fc/cureus-0016-00000060657-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/73e7/11186216/8b93089174f5/cureus-0016-00000060657-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/73e7/11186216/f317b40079fe/cureus-0016-00000060657-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/73e7/11186216/1393c36b1171/cureus-0016-00000060657-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/73e7/11186216/472ac6999fb4/cureus-0016-00000060657-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/73e7/11186216/0b9ad8a737e4/cureus-0016-00000060657-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/73e7/11186216/94ad9c20f9fc/cureus-0016-00000060657-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/73e7/11186216/8b93089174f5/cureus-0016-00000060657-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/73e7/11186216/f317b40079fe/cureus-0016-00000060657-i06.jpg

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本文引用的文献

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Does epidural analgesia really enhance recovery in pediatric surgery patients?硬膜外镇痛真的能促进小儿外科手术患者的康复吗？
Pediatr Surg Int. 2021 Sep;37(9):1201-1206. doi: 10.1007/s00383-021-04897-z. Epub 2021 Apr 8.
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A Review of Regional Anesthesia in Infants.婴儿区域麻醉述评。
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Enhancing Recovery After Kasai Portoenterostomy With Epidural Analgesia.硬膜外镇痛增强葛西手术后恢复。
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Major complications related to epidural analgesia in children: a 15-year audit of 3,152 epidurals.儿童硬膜外镇痛相关的主要并发症：3152 例硬膜外镇痛的 15 年回顾性研究。
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The effect of flexion on the level of termination of the dural sac in paediatric patients.屈曲对小儿患者硬脊膜囊终止水平的影响。
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Long-term impact of neonatal intensive care and surgery on somatosensory perception in children born extremely preterm.新生儿重症监护和手术对极早产儿出生后儿童体感感知的长期影响。
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