The Scalp Nerve Block Combined with Intercostal Nerve Block Improves Recovery After Deep Brain Stimulation in Patients with Parkinson's Disease: A Prospective, Randomized Controlled Trial.

IF 3.5 3区 医学 Q2 GERIATRICS & GERONTOLOGY Clinical Interventions in Aging Pub Date : 2024-11-08 eCollection Date: 2024-01-01 DOI:10.2147/CIA.S473421
Wenbin Lu, Xinning Chang, Wei Wu, Peipei Jin, Shengwei Lin, Lize Xiong, Xiya Yu
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Abstract

Objective: To explore the effect of scalp nerve block (SNB) combined with intercostal nerve block (ICNB) on quality of recovery (QoR) after deep brain stimulation (DBS) in patients with Parkinson's disease (PD).

Methods: We conducted a prospective randomized controlled trial in which 88 patients with PD were randomly assigned to undergo SNB combined with ICNB (SNB group) or not (control group) before surgery. The primary outcome was the 15-item QoR (QoR-15) score 24 h after surgery. The secondary outcomes included QoR-15 scores at 72 h and 1 month after surgery, pain-related events, recovery events in post-anesthesia care unit (PACU), duration of anesthesia and surgery, and nerve block-related adverse events.

Results: The QoR-15 score at 24 h after surgery was significantly higher in SNB group than Control group: 122.0 ± 7.6 vs 113.5 ± 11.3 (P = 0.006). SNB combined with ICNB improved QoR-15 scores at 72 h (P = 0.004) but not at 1 month after surgery (P = 0.230). The SNB group was positively related to QoR-15 scores 24 h after surgery (β = 8.92; 95% CI = 4.52~13.32) after adjusting for confounding variables. The numeric rating scale pain scores at PACU discharge and at 24 h, intraoperative opioid consumption, rescue analgesic use, and the incidence of postoperative nausea and vomiting (PONV) in SNB group were significantly lower than Control group (P < 0.05).

Conclusion: Preoperative SNB combined with ICNB improved QoR and analgesia after surgery, and reduced intraoperative opioid consumption and the incidence of PONV in patients with PD who underwent DBS.

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头皮神经阻滞结合肋间神经阻滞可改善帕金森病患者脑深部刺激后的恢复:前瞻性随机对照试验》。
目的探讨头皮神经阻滞(SNB)联合肋间神经阻滞(ICNB)对帕金森病(PD)患者深部脑刺激(DBS)术后恢复质量(QoR)的影响:我们进行了一项前瞻性随机对照试验,将 88 名帕金森病患者随机分配到术前接受 SNB 联合 ICNB(SNB 组)或不接受 SNB 联合 ICNB(对照组)。主要结果是手术后 24 小时的 15 项 QoR(QoR-15)评分。次要结果包括术后72小时和1个月的QoR-15评分、疼痛相关事件、麻醉后护理病房(PACU)恢复事件、麻醉和手术持续时间以及神经阻滞相关不良事件:术后 24 小时的 QoR-15 评分,SNB 组明显高于对照组:122.0 ± 7.6 vs 113.5 ± 11.3(P = 0.006)。SNB 联合 ICNB 可改善术后 72 小时的 QoR-15 评分(P = 0.004),但术后 1 个月的 QoR-15 评分没有改善(P = 0.230)。调整混杂变量后,SNB 组与术后 24 小时的 QoR-15 评分呈正相关(β = 8.92;95% CI = 4.52~13.32)。SNB组在PACU出院时和术后24 h的疼痛评分、术中阿片类药物的用量、镇痛抢救药物的用量以及术后恶心呕吐(PONV)的发生率均显著低于对照组(P < 0.05):结论:术前 SNB 联合 ICNB 可改善 PD 患者接受 DBS 手术后的 QoR 和镇痛效果,减少术中阿片类药物的用量和 PONV 的发生率。
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来源期刊
Clinical Interventions in Aging
Clinical Interventions in Aging GERIATRICS & GERONTOLOGY-
CiteScore
6.80
自引率
2.80%
发文量
193
审稿时长
6-12 weeks
期刊介绍: Clinical Interventions in Aging, is an online, peer reviewed, open access journal focusing on concise rapid reporting of original research and reviews in aging. Special attention will be given to papers reporting on actual or potential clinical applications leading to improved prevention or treatment of disease or a greater understanding of pathological processes that result from maladaptive changes in the body associated with aging. This journal is directed at a wide array of scientists, engineers, pharmacists, pharmacologists and clinical specialists wishing to maintain an up to date knowledge of this exciting and emerging field.
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