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区域麻醉在减少阿片类药物使用及促进患者康复中的作用:病例系列

Role of regional anesthesia in minimizing opioid use and enhancing patient recovery: a case series.

作者信息

Setiadi Irwan, Alifahna Muhammad Rezanda, Halimi Radian Ahmad, Bisri Dewi Yulianti

机构信息

Department of Anaesthesiology and Intensive Therapy, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Pasteur Street 38, Bandung, West Java, 40161, Indonesia.

出版信息

J Med Case Rep. 2025 Apr 16;19(1):177. doi: 10.1186/s13256-025-05177-3.

Abstract

BACKGROUND

Enhanced Recovery After Surgery employs evidence-based strategies to improve outcomes across the preoperative, intraoperative, and postoperative phases. In spinal surgery, compared with traditional management with general anesthesia, regional anesthesia offers benefits such as reduced pain, improved organ function, faster mobility, and shorter hospital stays. Studies have shown that regional anesthesia, particularly spinal anesthesia, results in shorter operation times, lower postoperative pain, and fewer thrombosis complications than does general anesthesia. The implementation of regional anesthesia in Enhanced Recovery After Surgery protocols for elective spinal surgeries aims to minimize hospital stays and opioid use, significantly enhancing recovery and patient outcomes.

PATIENT PRESENTATION

Two Sundanese patients underwent laminectomy surgery for chronic low back pain and disc degeneration. The first, a 57-year-old man, presented with bulging discs and osteophytes in the lumbar spine and underwent a 2-hour surgery in the prone position. His vital signs remained stable throughout. The second patient, a 54-year-old woman, also had similar lumbar spine issues and underwent equally successful surgery under stable hemodynamic conditions.

CONCLUSION

Regional anesthesia during lumbar spine surgery ensures stable perioperative hemodynamics and reduces opioid needs, which aligns with Enhanced Recovery After Surgery principles, promoting faster recovery and better outcomes.

摘要

背景

术后加速康复采用循证策略,以改善术前、术中和术后各阶段的治疗效果。在脊柱手术中,与全身麻醉的传统管理方式相比,区域麻醉具有减轻疼痛、改善器官功能、加快活动能力恢复以及缩短住院时间等益处。研究表明,区域麻醉,尤其是脊髓麻醉,与全身麻醉相比,手术时间更短、术后疼痛减轻且血栓形成并发症更少。在择期脊柱手术的术后加速康复方案中实施区域麻醉,旨在尽量缩短住院时间并减少阿片类药物的使用,显著促进康复及改善患者治疗效果。

患者情况

两名巽他族患者因慢性下腰痛和椎间盘退变接受了椎板切除术。第一名患者是一名57岁男性,腰椎间盘膨出并伴有骨赘,在俯卧位接受了2小时手术。术中其生命体征始终保持稳定。第二名患者是一名54岁女性,也有类似的腰椎问题,在血流动力学稳定的情况下同样成功接受了手术。

结论

腰椎手术期间采用区域麻醉可确保围手术期血流动力学稳定并减少对阿片类药物的需求,这符合术后加速康复原则,有助于促进更快康复和取得更好的治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4cd/12004740/3f42cf6a8ba9/13256_2025_5177_Fig1_HTML.jpg

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