Brazilian Journal of Anesthesiology最新文献_第3页

Evolution of patients with chronic pain undergoing standard treatment: a prospective longitudinal follow-up study 接受标准治疗的慢性疼痛患者的演变：一项前瞻性纵向随访研究。

IF 1.9 4区医学 Q2 ANESTHESIOLOGY

Brazilian Journal of Anesthesiology

Pub Date : 2025-11-01 DOI: 10.1016/j.bjane.2025.844700

Camila Cavalcante Castro , Sandro Max C. Silva , Martha Moreira C. Castro , Durval Campos Kraychete , Carla Daltro

Introduction

Chronic pain greatly affects quality of life and, consequently, impacts the psychological state, a condition that needs to be addressed. A 30% reduction in pain intensity is clinically significant. The objective of this study was to describe the clinical and psychological aspects of individuals with chronic pain undergoing standard treatment.

Methods

Descriptive longitudinal study involving individuals with chronic pain undergoing treatment at the Pain Outpatient Clinic of the Federal University of Bahia, in Salvador, Bahia, between June 2016 and December 2017. The variables studied were pain intensity, quality of life, sleep disorders, stress level, and the presence of anxiety and depression symptoms. Descriptive statistics were performed, and Student's t-test, and Fisher's Chi-Square test were used to compare the groups.

Results

We studied 134 individuals with a mean (standard deviation) age of 50 (10) years, 89.6% of whom were female. There was an improvement in quality of life and sleep, anxiety and depressive symptoms, and 58.2% of patients showed a 30% reduction in pain intensity. Among the factors associated with pain reduction, having a partner was a significant factor (73.7% vs. 52.1%; p = 0.030). However, symptoms of anxiety (81.6% vs. 75.0%; p = 0.436), symptoms of depression (63.2% vs. 58.3%; p = 0.718), and stress (92.1% vs. 87.5%; p = 0.846) were not associated with pain reduction.

Conclusion

This study suggests that multidisciplinary treatment can reduce pain intensity in chronically affected patients, as most patients exhibited a clinically significant response, accompanied by global improvement.

慢性疼痛极大地影响生活质量，从而影响心理状态，这是一个需要解决的问题。疼痛强度降低30%具有临床意义。本研究的目的是描述慢性疼痛接受标准治疗的个体的临床和心理方面。方法：描述性纵向研究涉及2016年6月至2017年12月在巴伊亚州萨尔瓦多巴伊亚联邦大学疼痛门诊接受治疗的慢性疼痛患者。研究的变量包括疼痛强度、生活质量、睡眠障碍、压力水平以及焦虑和抑郁症状的存在。采用描述性统计，采用Student’st检验和Fisher’s卡方检验进行组间比较。结果：我们研究了134例平均（标准差）年龄为50（10）岁的个体，其中89.6%为女性。患者的生活质量、睡眠质量、焦虑和抑郁症状均有所改善，58.2%的患者疼痛强度减轻了30%。在与疼痛减轻相关的因素中，有伴侣是显著因素（73.7% vs. 52.1%; p = 0.030）。然而，焦虑症状（81.6% vs. 75.0%; p = 0.436）、抑郁症状（63.2% vs. 58.3%; p = 0.718）和压力（92.1% vs. 87.5%; p = 0.846）与疼痛减轻无关。结论：本研究表明，多学科治疗可以减轻慢性疼痛患者的疼痛强度，因为大多数患者表现出显著的临床反应，并伴有整体改善。

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引用次数: 0

Feasibility of early rapid sequence induction and intubation training and the role of a cognitive aid on-demand reader in medical students: lessons from a pilot randomized study 早期快速序列诱导和插管训练的可行性以及认知辅助按需阅读器在医学生中的作用：来自一项试点随机研究的经验教训。

IF 1.9 4区医学 Q2 ANESTHESIOLOGY

Brazilian Journal of Anesthesiology

Pub Date : 2025-10-31 DOI: 10.1016/j.bjane.2025.844701

Getúlio Rodrigues de Oliveira Filho, Miguel Angelo Fabrin, Victor Medeiros Benincá, Ian Novy Quadri, Gabriel Resun Gomes da Silva

引用次数: 0

Preoperative pulmonary ultrasound: a valuable tool for managing post-COVID-19 sequelae 术前肺部超声：处理covid -19后后遗症的宝贵工具

IF 1.9 4区医学 Q2 ANESTHESIOLOGY

Brazilian Journal of Anesthesiology

Pub Date : 2025-10-29 DOI: 10.1016/j.bjane.2025.844697

Luis Alberto Rodrigues Linares , Victória Regina da Silva Oliveira , Lais Helena Navarro e Lima , Rodrigo Moreira e Lima , Camila Squarzoni Dale

引用次数: 0

Comparative effectiveness of TAP block, EOIP block, and standard care for postoperative analgesia in renal transplantation: a retrospective study TAP阻滞、EOIP阻滞和标准护理对肾移植术后镇痛的比较效果：一项回顾性研究

IF 1.9 4区医学 Q2 ANESTHESIOLOGY

Brazilian Journal of Anesthesiology

Pub Date : 2025-10-24 DOI: 10.1016/j.bjane.2025.844692

Karam Azem , Roussana Aranbitski , Safo Awad , Omer Shpack , Alexander Peres , Rotem Argov , Omer Kaplan , Anatoliy Artyukh , Andrey Khinchuk , Michael Yohay Stav , Philip Heesen , Sharon Orbach-Zinger , Eviatar Nesher , Shai Fein

Background

Effective pain management following renal transplantation is crucial. While various regional analgesic techniques have been studied, the optimal approach remains unclear. We compared the additive value of Transversus Abdominis Plane (TAP) and External Oblique Intercostal Plane (EOIP) blocks to Standard Care (SC) on postoperative pain and opioid consumption.

Methods

This retrospective study included 237 renal transplant recipients (127 SC, 75 TAP, 35 EOIP) between January 2023 and December 2024. Multivariable regression analysis assessed the association of block type on postoperative pain and opioid consumption.

Results

TAP block was associated with significantly lower pain scores than SC during the first eight postoperative hours (5.0 vs. 7.0, p < 0.001). Pre-incision TAP block demonstrated the most significant reduction in both pain scores (β = -2.21, 95% CI -3.38 to -1.05, p < 0.001) and opioid consumption (β = -13.56, 95% CI: -21.59 to -5.52, p = 0.001). EOIP block showed no significant advantages over SC and was associated with higher opioid consumption compared to TAP block.

Conclusion

Pain predominantly manifested in the first eight postoperative hours. TAP block, particularly when administered pre-incision, was associated with superior pain control compared to SC or EOIP block. Living donor recipients experienced significantly higher pain scores regardless of technique, warranting further investigation.

肾移植后有效的疼痛管理是至关重要的。虽然研究了各种局部镇痛技术，但最佳方法仍不清楚。我们比较了经腹平面（TAP）和外斜肋间平面（EOIP）阻滞与标准护理（SC）对术后疼痛和阿片类药物消耗的附加价值。方法回顾性研究了2023年1月至2024年12月237例肾移植受者（SC 127例，TAP 75例，EOIP 35例）。多变量回归分析评估阻滞类型与术后疼痛和阿片类药物消耗的关系。结果术后前8小时，stap阻滞的疼痛评分明显低于SC （5.0 vs. 7.0, p < 0.001）。切开前TAP阻滞在疼痛评分（β = -2.21, 95% CI: -3.38至-1.05,p < 0.001）和阿片类药物消耗（β = -13.56, 95% CI: -21.59至-5.52,p = 0.001）方面均表现出最显著的降低。与SC相比，EOIP阻断没有明显的优势，与TAP阻断相比，它与更高的阿片类药物消耗有关。结论疼痛主要表现在术后前8小时。与SC或EOIP阻滞相比，TAP阻滞，特别是在切口前给药时，与更好的疼痛控制相关。无论采用何种技术，活体供体接受者的疼痛评分明显更高，值得进一步研究。

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引用次数: 0

Effect of lidocaine and magnesium sulfate on rocuronium onset time: a randomized controlled experimental study 利多卡因和硫酸镁对罗库溴铵起效时间的影响：一项随机对照实验研究

IF 1.9 4区医学 Q2 ANESTHESIOLOGY

Brazilian Journal of Anesthesiology

Pub Date : 2025-10-24 DOI: 10.1016/j.bjane.2025.844696

Michele Cocenza Varrichio Crispim , Denise Aya Otsuki , Yuri Ferreira Vicentini , Danielly Roberta Penedo Rodrigues , Milena Gomes Parzianello Egúsquiza , José Otavio Costa Auler Junior

Background

Neuromuscular blockers such as succinylcholine are widely used for airway management in critically ill patients; but their use may be contraindicated due to adverse effects. In rapid sequence intubation, the onset time of the neuromuscular blocker is critical and should be as short as possible. This study investigates whether lidocaine and magnesium sulfate could reduce the onset time of rocuronium bromide in an experimental model.

Method

Eighteen animals were randomly assigned to three groups and treated with lidocaine, magnesium sulfate, or saline before receiving rocuronium bromide (3 mg.kg^-1). After 10 minutes of neuromuscular blockade, reversal was performed with sugammadex (9 mg.kg^-1). Onset and reversal times were measured by acceleromyography. Doses were standardized in a pilot study with four animals. Data were tested for normality using the Shapiro-Wilk and Anderson-Darling tests. Onset times are tested with a one-way ANOVA, followed by Fisher’s (LSD) post hoc test, and mean arterial pressure and heart rate with a two-way ANOVA, followed by Tukey’s post hoc test. Statistical significance was set at p ≤ 0.05.

Results

The results showed that lidocaine and magnesium sulfate significantly reduced the onset time of rocuronium bromide compared to the saline solution (p < 0.05) and did not affect the onset time of reversal with sugammadex (p > 0.05). Both adjuvants caused hypotension, with a more significant effect observed with magnesium sulfate; however, blood pressure returned to baseline values.

Conclusion

In conclusion, lidocaine and magnesium sulfate facilitate airway access by reducing the onset time of rocuronium bromide.

Animal Ethics Committee approved 1749/2022.

神经肌肉阻滞剂如琥珀酰胆碱被广泛用于危重病人的气道管理；但由于不良反应，它们的使用可能是禁忌的。在快速序贯插管中，神经肌肉阻滞剂的起效时间至关重要，应尽可能短。本研究在实验模型中探讨利多卡因和硫酸镁是否能缩短罗库溴铵的起效时间。方法18只动物随机分为3组，分别给予利多卡因、硫酸镁或生理盐水治疗，然后给予罗库溴铵（3mg .kg-1）。神经肌肉阻断10分钟后，用糖马德（9 mg.kg-1）进行逆转。用加速肌图测定起病时间和逆转时间。在4只动物的初步研究中，剂量被标准化了。使用Shapiro-Wilk和Anderson-Darling检验数据的正态性。发病时间采用单因素方差分析，随后进行Fisher （LSD）事后检验，平均动脉压和心率采用双因素方差分析，然后进行Tukey事后检验。p≤0.05为差异有统计学意义。结果与生理盐水相比，利多卡因和硫酸镁可显著缩短罗库溴铵的起效时间（p < 0.05），而对糖马德逆转的起效时间无影响（p > 0.05）。两种佐剂均可引起低血压，硫酸镁的效果更显著；然而，血压恢复到基线值。结论利多卡因和硫酸镁可通过缩短罗库溴铵起效时间促进气道通路。动物伦理委员会批准1749/2022。

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引用次数: 0

Efficacy of magnesium sulfate as an adjuvant to local anesthetics in supraclavicular brachial plexus block: a meta-analysis of randomized trials 硫酸镁辅助局部麻醉剂治疗锁骨上臂丛神经阻滞的疗效：随机试验的荟萃分析。

IF 1.9 4区医学 Q2 ANESTHESIOLOGY

Brazilian Journal of Anesthesiology

Pub Date : 2025-10-16 DOI: 10.1016/j.bjane.2025.844689

Willyam Barros Saraiva , Isadora Eloy Candido , Roberta Ribeiro Brandão Caldas , Fabiano Timbó Barbosa

Background

Magnesium Sulfate (MS) maintains physiological functions in the body. Studies suggest its safety in regional anesthesia, despite off-label perineural use. We conducted a systematic review and meta-analysis to evaluate MS efficacy as an adjuvant in supraclavicular brachial plexus block.

Methods

The study was registered in PROSPERO (CRD42025641627) on 01/21/2025. We searched PUBMED, Embase, Cochrane, clinicaltrials.gov and gray literature for eligible studies. We included RCTs that: enrolled adult patients; involved orthopedic surgery with supraclavicular block; compared LA alone versus LA with MS; and reported primary outcomes. Primary outcomes were duration of sensory and motor block, while secondary outcomes included onset of sensory and motor block, PONV and rescue analgesia needs postoperatively. RoB2 tool and GRADE assessed bias risk and evidence certainty. Variables were examined using DerSimonian-Laird random-effects model.

Results

Analysis included 10 studies and 734 patients. The intervention group showed longer sensory and motor block than controls. The Mean Difference (MD) was 180.84 minutes (95% CI [154.09, 207.59], 95% PI [71.67, 289.77], p < 0.00001, I² = 97%) and 151.26 minutes (95% CI [99.78, 202.74], 95% PI [-23.12, 325.63], p < 0.00001, I² = 99%). The magnesium group showed statistical difference in onset of sensory and motor blockade and rescue analgesia needs, with no difference in PONV. Evidence certainty was rated low to moderate. Risk of bias “high” in three studies, “some concerns” in four studies and “low” in three studies.

Conclusion

Our meta-analysis supports MS as adjuvant in supraclavicular block. Further research is needed due to high heterogeneity.

PROSPERO registration

CRD42025641627.

背景：硫酸镁（Magnesium Sulfate， MS）在体内维持生理功能。研究表明它在区域麻醉中的安全性，尽管在标签外的神经周围使用。我们进行了一项系统回顾和荟萃分析，以评估MS作为锁骨上臂丛神经阻滞的辅助治疗效果。方法：该研究于2025年1月21日在PROSPERO注册（CRD42025641627）。我们检索了PUBMED、Embase、Cochrane、clinicaltrials.gov和灰色文献，寻找符合条件的研究。我们纳入的随机对照试验包括：入组成年患者；伴锁骨上阻滞的累及骨科手术；比较LA单独与LA合并MS；并报告了主要结果。主要结局是感觉和运动阻滞的持续时间，次要结局包括感觉和运动阻滞的发生、PONV和术后抢救镇痛需求。RoB2工具和GRADE评估偏倚风险和证据确定性。变量检验采用dersimonan - laird随机效应模型。结果：纳入10项研究，734例患者。干预组表现出较长时间的感觉和运动阻滞。MD分别为180.84分钟（95% CI [154.09, 207.59], 95% PI [71.67, 289.77], p < 0.00001, I² = 97%）和151.26分钟（95% CI [99.78, 202.74], 95% PI [-23.12, 325.63], p < 0.00001, I² = 99%）。镁组在感觉和运动阻断的发生及救援性镇痛需要方面有统计学差异，而PONV无统计学差异。证据确定性被评为低至中等。3项研究偏倚风险为“高”，4项研究偏倚风险为“一些关注”，3项研究偏倚风险为“低”。结论：我们的荟萃分析支持MS作为锁骨上阻滞的辅助治疗。异质性高，有待进一步研究。普洛斯彼罗注册：CRD42025641627。

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引用次数: 0

Correlation between impostor phenomenon and burnout syndrome in medical residents: a single-center study 住院医师冒名顶替现象与倦怠综合征的相关性：一项单中心研究。

IF 1.9 4区医学 Q2 ANESTHESIOLOGY

Brazilian Journal of Anesthesiology

Pub Date : 2025-10-15 DOI: 10.1016/j.bjane.2025.844688

Cristina González Ramírez, Rocío Pérez Bocanegra, Carlos Armando Sánchez-Navarro

引用次数: 0

Independent preoperative predictors of day-of-surgery red cell transfusion in major orthopedic surgery: a six-year retrospective cohort of 7072 patients 大型骨科手术中红细胞输血的独立术前预测因素：7072例患者的6年回顾性队列研究

IF 1.9 4区医学 Q2 ANESTHESIOLOGY

Brazilian Journal of Anesthesiology

Pub Date : 2025-10-11 DOI: 10.1016/j.bjane.2025.844685

José R. Ortiz-Gómez , Andrea Ortiz-Domínguez , Inocencia Fornet-Ruíz , Francisco J. Palacio-Abizanda

Background

Major Orthopedic Surgery (MOS) is frequently associated with significant blood loss, potentially resulting in perioperative anemia and the need for allogeneic blood transfusion, which carries inherent risks. This study aimed to identify independent preoperative predictors of early Packed Red Blood Cell (PRBC) transfusion in patients undergoing MOS.

Methods

We analyzed, retrospectively, data from 7072 patients who underwent MOS. The variables assessed included age, sex, weight, height, Body Mass Index (BMI), ASA (American Society of Anesthesiologists) physical status classification, surgical category (hip, knee, spine), type of procedure (primary or revision total hip/knee arthroplasty, spinal arthrodesis, scoliosis surgery), preoperative hemoglobin levels and levels at 8:00 AM on postoperative day 1, hemoglobin thresholds (> 13, < 13, < 12, < 11, and < 10 g.dL^-1), administration of tranexamic acid, and the requirement for PRBC transfusion.

Results

The overall transfusion rate was 4.8 % (3.6 % for hip, 2.7 % for knee, and 15.0 % for spine surgery). Independent predictors of PRBC transfusion included: preoperative hemoglobin < 13 g.dL^-1 (Relative Risk [RR] 6.55), high-risk surgical procedures (RR = 7.40), ASA physical status III‒IV (RR = 2.00), absence of tranexamic acid use (RR = 2.52), and, to a lesser extent, age > 75 years (RR = 1.50). The combination of all identified risk factors was associated with a markedly increased transfusion risk (RR = 14.55; p < 0.0001).

Conclusion

These findings have informed modifications to our clinical practice, aimed at enhancing quality standards through the implementation of more effective Patient Blood Management (PBM) strategies.

背景：大骨科手术（MOS）经常伴有大量失血，可能导致围手术期贫血和需要异基因输血，这具有固有的风险。本研究旨在确定MOS患者早期填充红细胞（PRBC）输血的独立术前预测因素。方法：回顾性分析7072例MOS患者的资料。评估的变量包括年龄、性别、体重、身高、身体质量指数（BMI）、ASA（美国麻醉医师协会）身体状态分类、手术类别（髋关节、膝关节、脊柱）、手术类型（原发性或改良性全髋关节/膝关节置换术、脊柱融合术、脊柱侧凸手术）、术前和术后第1天上午8:00血红蛋白水平、血红蛋白阈值（bbb13、< 13、< 12、< 11和< 10 g.dL-1）、氨甲环酸给药、以及输血PRBC的要求。结果：总体输血率为4.8%（髋部3.6%，膝关节2.7%，脊柱15.0%）。PRBC输血的独立预测因素包括：术前血红蛋白< 13 g.dL-1（相对危险度[RR] 6.55），高危手术（RR = 7.40），ASA身体状态III-IV (RR = 2.00)，未使用氨甲环酸（RR = 2.52），以及较小程度的年龄（RR = 1.50）。所有确定的危险因素的组合与输血风险显著增加相关（RR = 14.55;p < 0.0001）。结论：这些发现为我们的临床实践提供了修改信息，旨在通过实施更有效的患者血液管理（PBM）策略来提高质量标准。

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引用次数: 0

Hypertonic saline versus mannitol for brain relaxation in supratentorial tumor surgery: a prospective randomized trial 高渗盐水与甘露醇在幕上肿瘤手术中的脑松弛作用：一项前瞻性随机试验。

IF 1.9 4区医学 Q2 ANESTHESIOLOGY

Brazilian Journal of Anesthesiology

Pub Date : 2025-09-16 DOI: 10.1016/j.bjane.2025.844684

Eren Fatma Akcil, Ozlem Korkmaz Dilmen, Yusuf Tunali

Background

Hypertonic saline and mannitol are widely used to improve brain relaxation during supratentorial mass surgeries. Although continuous administration of hypertonic saline is known to reduce intracranial pressure, it has not yet been evaluated in supratentorial mass surgeries.

Methods

After institutional ethical committee approval, 92 patients scheduled for supratentorial craniotomy with glioblastoma multiforme, metastasis and/or midline shift (> 0.5 cm) were enrolled into this prospective, randomized, and double-blind study. The patients received hypertonic saline 3 mL.kg^-1 bolus, hypertonic saline infusion 20 mL.h^-1 or 20 % mannitol 0.6 gr.kg^-1 after head positioning. Brain relaxation score (1 = Perfectly relaxed, 2 = Satisfactorily relaxed, 3 = Firm brain and 4 = Bulging brain) was the primary outcome. Sodium and chlorine levels were the secondary outcomes. Postoperative brain edema and midline shift were assessed.

Results

After randomization, two patients were excluded from the study. Brain relaxation scores were higher with hypertonic saline bolus compared to mannitol (p = 0.047). The effect size between groups for brain relaxation score was 0.22. Hypertonic saline continuous infusion and mannitol were similar with respect to brain relaxation scores. Sodium and chlorine levels were lower in the mannitol group. Postoperative midline shift and edema were lower with continuous hypertonic saline compared to other groups (p = 0.001, p = 0.006).

Conclusion

Continuous infusion of 3 % hypertonic saline was associated with better relaxation scores in the intraoperative period and with lower incidences of edema/midline shift in the postoperative period of supratentorial mass surgeries with glioblastoma multiforme, metastasis and/or midline shift.

背景：高渗盐水和甘露醇被广泛应用于幕上肿块手术中改善大脑放松。虽然已知持续给予高渗生理盐水可降低颅内压，但尚未对幕上肿块手术进行评估。方法：经机构伦理委员会批准，92例多形性胶质母细胞瘤、转移和/或中线移位（> 0.5 cm）的幕上开颅手术患者纳入这项前瞻性、随机、双盲研究。患者头部定位后给予高渗盐水3 mL.kg-1，高渗盐水20 mL.h-1或20%甘露醇0.6 g. kg-1。脑放松评分（1 = 完全放松，2 = 满意放松，3 = 脑结实，4 = 脑膨出）为主要观察指标。钠和氯水平是次要指标。评估术后脑水肿和中线移位。结果：随机分组后，2例患者被排除在研究之外。高渗生理盐水组脑放松评分高于甘露醇组（p = 0.047）。脑放松评分组间效应量为0.22。高渗盐水持续输注和甘露醇在脑放松评分方面相似。甘露醇组的钠和氯含量较低。与其他组相比，持续高渗盐水组术后中线移位和水肿更低（p = 0.001,p = 0.006）。结论：持续输注3%高渗生理盐水对幕上肿物手术合并多形性胶质母细胞瘤、转移和/或中线移位患者术中松弛评分较高，术后水肿/中线移位发生率较低。

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引用次数: 0

Comparison of three quadratus lumborum block approaches for pediatric lower abdominal surgeries: a randomized controlled trial 小儿下腹部手术三种腰方肌阻滞入路的比较：一项随机对照试验。

IF 1.9 4区医学 Q2 ANESTHESIOLOGY

Brazilian Journal of Anesthesiology

Pub Date : 2025-09-11 DOI: 10.1016/j.bjane.2025.844683

Arun SK , Ajeet Kumar , Amarjeet Kumar , Chandni Sinha , Abhyuday Kumar , Poonam Kumari , Bindey Kumar

Background

Lower abdominal surgeries in the pediatric population are associated with significant post-operative pain. Regional anesthesia techniques including ilioinguinal nerve block, Transversus Abdominis Plane (TAP) block, and Quadratus Lumborum (QL) block have been explored for lower abdominal surgeries. This study compares the analgesic effect of three different approaches to quadratus lumborum block in pediatric patients undergoing lower abdominal surgeries.

Methods

This randomized controlled trial included 120 pediatric patients aged between 1 and 7 years, scheduled for lower abdominal surgery under general anesthesia. Patients were randomized into 3 groups. Patients of Group A received QL block via anterior approach, Group L received QL block via lateral approach, and Group P received QL block via posterior approach. A volume of 0.5 mL.kg^-1 of 0.375% ropivacaine was injected unilaterally for QL block in all patients. The primary outcome was 24hr postoperative fentanyl consumption. Secondary outcomes included intraoperative fentanyl use, postoperative pain scores, time to rescue analgesia and parental satisfaction.

Results

Postoperative mean fentanyl consumption was significantly lower in Group A as compared to Group L (p < 0.001) and Group P (p < 0.011). Postoperative median FLACC scores were significantly lower (p < 0.05) in Group A in comparison to Group L and Group P in the early postoperative period. The parent satisfaction score was significantly higher (p < 0.05) in Group A.

Conclusion

Anterior approach to QL block reduces postoperative analgesic consumption and provides longer duration analgesia with better parental satisfaction scores in comparison to lateral and posterior approaches in pediatric patients undergoing lower abdominal surgeries.

背景：小儿下腹部手术与明显的术后疼痛相关。区域麻醉技术包括髂腹股沟神经阻滞、腹横面阻滞和腰方肌阻滞用于下腹部手术。本研究比较了小儿下腹部手术中腰方肌阻滞的三种不同入路的镇痛效果。方法：本随机对照试验纳入120例1 ~ 7岁的儿科患者，计划在全身麻醉下进行下腹部手术。患者随机分为3组。A组经前路行QL阻滞，L组经外侧入路行QL阻滞，P组经后路行QL阻滞。所有患者均单侧注射0.375%罗哌卡因0.5 mL.kg-1进行QL阻滞。主要终点为术后24小时芬太尼用量。次要结局包括术中芬太尼使用、术后疼痛评分、镇痛恢复时间和家长满意度。结果：A组术后芬太尼平均用量显著低于L组（p < 0.001）和p组（p < 0.011）。术后早期A组FLACC中位评分明显低于L组和p组（p < 0.05）。a组家长满意度评分显著高于对照组（p < 0.05）。结论：与侧路和后路相比，前路行QL阻滞可减少术后镇痛消耗，镇痛持续时间更长，家长满意度评分更高。

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引用次数: 0