不同年龄儿童前腹壁以患者为中心镇痛的体会

IF 0.2 Q4 ANESTHESIOLOGY Anaesthesia, Pain & Intensive Care Pub Date : 2021-11-25 DOI:10.25284/2519-2078.4(97).2021.248396
Y. Semkovych, D. Dmytriiev, Y. Glazov
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引用次数: 0

摘要

介绍。在儿科实践中,区域麻醉是围手术期疼痛管理中最有价值和最安全的工具之一。区域麻醉的优点是儿童的早期恢复,减少阿片类药物的消耗,术后疼痛,呼吸并发症,恶心,呕吐,以及医疗保健费用。本研究的目的是分析腰方肌阻滞和筋膜横肌阻滞对术后镇痛持续时间和效果的影响数据,提出两阻滞单次注射相结合的模型。材料和方法。今天有越来越多的兴趣在使用新的区域麻醉方法,特别是前部和后部躯干阻滞。腰方肌阻滞和筋膜横肌阻滞的目的是在T7-L1皮节上提供镇痛,即髂腹股沟神经和髂神经,它们从大腰肌外侧延伸至第12肋骨的下缘;然而,有证据表明颅部扩散到T4 - T5皮节,尾部扩散到L2 - L3皮节。目前,关于腰方肌阻滞和筋膜横肌阻滞的文献已经足够多。为了获得足够的围手术期多模式麻醉,作者建议采用筋膜横肌阻滞和腰方肌阻滞联合单次注射和超声引导。所提出的方法的优点包括简单,侵入性小,术中以及术后镇痛充分(排除躯体和内脏成分),视觉模拟评分(不超过两分)的评估证明了这一点。此外,它还显著减少了围手术期阿片类药物的使用。
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PATIENT-CENTERED ANALGESIA OF THE ANTERIOR ABDOMINAL WALL IN CHILDREN OF DIFFERENT AGES: OWN EXPERIENCE
Introduction. Regional anesthesia in pediatric practice is one of the most valuable and safest tools for perioperative pain management. The advantages of regional anesthesia are early recovery of children, reducing opioid consumption, postoperative pain, respiratory complications, nausea, vomiting, as well as health care costs. The aim of the study was to analyze the data on the effect of the quadratus lumborum block and the transversalis fascia block on the duration and effectiveness of postoperative analgesia and propose a model of combining two blocks with a single injection. Materials and methods. Today there is growing interest in the use of new methods of regional anesthesia, especially the anterior and posterior torso blocks. The quadratus lumborum block and the transversalis fascia block are aimed at providing analgesia over the T7-L1 dermatomes, namely the ilio-inguinal and iliac nerves, which extend from the lateral portion of the psoas major, the lower edge of the 12th rib; however, there is evidence of cranial spread to the T4 – T5 dermatomes, and caudal spread to the L2 – L3 dermatomes. Currently, there are enough publications concerning the quadratus lumborum block and the transversalis fascia block. Results. For adequate perioperative multimodal anesthesia, the authors proposed a combination of the transversalis fascia block and the quadratus lumborum block with a single injection and ultrasound guidance. Conclusions. The advantages of the proposed method include simplicity, less invasiveness, adequate analgesia during surgery, as well as during the postoperative period (exclusion of somatic and visceral components), as evidenced by the assessment on a visual analogue scale (no more than two points). In addition, it significantly reduces the perioperative opioid use.
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来源期刊
CiteScore
0.40
自引率
0.00%
发文量
56
审稿时长
4 weeks
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