腹部肌肉浸润镇痛治疗自体耳再造术中的供体部位疼痛:随机对照临床试验。

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引用次数: 0

摘要

背景:肋软骨供体部位疼痛是自体耳再造术的一种不良反应。本研究旨在引入腹直肌和外斜肌浸润镇痛(RAM+EOM-IA)治疗肋软骨供体部位疼痛,并评估其疗效和安全性:该研究是一项随机对照临床试验。患者被随机分为间歇性RAM+EOM-IA联合静脉患者控制麻醉(IPCA)和单纯IPCA两种。RAM+EOM-IA联合IPCA组和单独IPCA组分别随访了30名和30名患者。主要结果是术后 48 小时内记录的疼痛数字评分(NRS)。次要结果包括巴特尔指数(BI)和抢救镇痛药消耗量。使用冷刺激测试感觉阻滞区域:结果:28 小时后,RAM+EOM-IA 联合 IPCA 的 NRS 明显低于单用 IPCA 的 NRS(P 结论:RAM+EOM-IA 与 IPCA 联合使用能有效减轻术后疼痛:RAM+EOM-IA通过阻断小耳畸形患者T6至T10肋间神经的前侧和外侧皮支,有效、安全地预防了肋软骨供体部位疼痛。
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Abdominal muscles infiltration analgesia for donor-site pain in autologous ear reconstruction: A randomized controlled clinical trial

Background

Costal cartilage donor-site pain is an adverse effect of autologous ear reconstruction. This study aimed to introduce rectus abdominis and external oblique muscle infiltration analgesia (RAM+EOM-IA) for costal cartilage donor-site pain and evaluate its efficacy and safety.

Methods

The study was a randomized controlled clinical trial. Patients were randomized between intermittent RAM+EOM-IA combined with intravenous patient-controlled anesthesia (IPCA) and IPCA alone. Thirty patients were followed in the RAM+EOM-IA combined with the IPCA group and 30 patients in the IPCA alone group. The primary outcome was the numerical rating score (NRS) of pain recorded during 48 h postoperatively. Secondary outcomes included the Barthel index (BI) and rescue analgesic consumption. Sensory block areas were tested using a cold stimulus.

Results

NRS was significantly lower with RAM+EOM-IA combined with IPCA than with IPCA alone at 28 h (P < 0.01), 32 h (P < 0.01), 36 h (P < 0.01), 44 h (P < 0.001), and 48 h (P < 0.01) postoperatively. The number of patients who received rescue analgesics (P < 0.01) and consumption (P < 0.01) was significantly higher for IPCA alone. RAM+EOM-IA improved the BI at 24 h postoperatively (P < 0.001), especially for mobility (P < 0.001), using the stairs (P < 0.001) and toilet use domains (P < 0.001). At 10 and 60 min after RAM+EOM-IA, the total sensory block area in the abdomen had not extended proximally beyond the xiphoid, distally beyond the navel, and beyond midaxillary and midsternal lines on either side.

Conclusion

RAM+EOM-IA effectively and safely prevented costal cartilage donor-site pain by blocking anterior and lateral cutaneous branches of intercostal nerves from T6 to T10 in microtia patients.
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来源期刊
CiteScore
3.10
自引率
11.10%
发文量
578
审稿时长
3.5 months
期刊介绍: JPRAS An International Journal of Surgical Reconstruction is one of the world''s leading international journals, covering all the reconstructive and aesthetic aspects of plastic surgery. The journal presents the latest surgical procedures with audit and outcome studies of new and established techniques in plastic surgery including: cleft lip and palate and other heads and neck surgery, hand surgery, lower limb trauma, burns, skin cancer, breast surgery and aesthetic surgery.
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