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回顾性评估髂前嵴取骨新术式(髂前阻滞)的术后镇痛效果。

Retrospective evaluation of postoperative analgesia efficacy of a new technique in anterior iliac crest bone graft harvesting: anterior iliac block.

机构信息

Department of Anesthesiology and Reanimation, Kocaeli University, Kocaeli, Turkey.

Department of Orthopedics and Traumatology, Kocaeli University, Kocaeli, Turkey.

出版信息

BMC Anesthesiol. 2024 Nov 29;24(1):443. doi: 10.1186/s12871-024-02829-7.

Abstract

BACKGROUND

In reconstructive surgeries, iliac crest bone graft harvesting is commonly preferred. The pain experienced after surgery at the anterior iliac crest (AIC) donor site might be more intense compared to the pain at the primary surgical area where the graft is placed. To address this issue, we defined a novel technique called the anterior iliac block (AIB), which can provide analgesia with lower volumes. In this study, the effect of this technique for AIC bone greft harvesting was evaluated.

METHODS

Patients who were operated on and had AIC bone graft harvested included in this retrospective study. The study collected age, height, weight, ASA classification, and duration of surgery, information on the regional anesthesia technique, block performance, postoperative pain severity, opioid consumption, rescue analgesics used in the first postoperative 24 h.

RESULTS

Data from 16 patients were analyzed. The popliteal sciatic block was performed in eight patients, infraclavicular brachial plexus block in four patients, supraclavicular brachial plexus block in one patient, PENG block in one patient, and proximal adductor canal block in two patients two provide analgesia for primary surgery. The median morphine consumption at postoperative 24th hour was 3.5 mg, median NRS score was 1 at postoperative 1st hour, and 0 at postoperative 6th, 12th and 24th hours.

CONCLUSIONS

The study findings indicate that the AIB provides adequate analgesia for AIC graft harvesting in the first postoperative 24-hour period. It can be used as an adjuvant to the peripheric nerve block for the primary surgical site.

TRIAL REGISTRATION

NCT06295224.

摘要

背景

在重建手术中,通常首选髂嵴骨移植。与移植部位的原发性手术区域相比,前髂嵴(AIC)供体部位手术后的疼痛可能更剧烈。为了解决这个问题,我们定义了一种新的技术,称为前髂嵴阻滞(AIB),它可以用较低的容量提供镇痛。在这项研究中,评估了该技术在前髂嵴骨移植中的效果。

方法

本回顾性研究纳入了接受 AIC 骨移植的患者。该研究收集了患者的年龄、身高、体重、ASA 分级、手术时间、区域麻醉技术、阻滞效果、术后疼痛严重程度、术后 24 小时内阿片类药物消耗、使用的补救性镇痛药物等信息。

结果

分析了 16 例患者的数据。8 例患者行腘窝坐骨神经阻滞,4 例患者行锁骨下臂丛神经阻滞,1 例患者行锁骨上臂丛神经阻滞,1 例患者行 PENG 阻滞,2 例患者行近端收肌管阻滞以提供原发性手术的镇痛。术后 24 小时吗啡消耗量中位数为 3.5mg,术后 1 小时 NRS 评分为 1,术后 6、12 和 24 小时 NRS 评分为 0。

结论

研究结果表明,AIB 在前髂嵴移植后的 24 小时内提供了足够的镇痛。它可以作为原发性手术部位周围神经阻滞的辅助手段。

试验注册

NCT06295224。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e3f/11605857/ff5c3bc7c9a2/12871_2024_2829_Fig1_HTML.jpg

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