Use of regional anesthesia within a pediatric interventional radiology suite reduced periprocedural opioid use without delaying the overall workflow: a retrospective study.
Jordan I Gaelen, Chunyi Wu, Amy Yang, Shankar Rajeswaran, Alina Lazar, Eric C Cheon, Angelica A Vargas
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引用次数: 0
Abstract
Background: Nerve block utility has been extensively described in the operating room, however, there is a paucity of evidence regarding blocks in the interventional radiology (IR) suite, with no studies examining its safety and efficacy in children.
Methods: A retrospective study was conducted at a single tertiary-care children's hospital to evaluate the analgesic utility of nerve blocks during IR-performed sclerotherapy for bone cysts, venous malformations, and lymphatic malformations. Lymphatic and venous malformations were combined for final analysis. Patients between January 2016 and September 2022 had their medical records reviewed for procedural data, postprocedural pain scores, and analgesic administration data.
Results: 309 patients were included in the final analysis. Opioids were required significantly less frequently intraprocedurally and postprocedurally across subgroups. The proportion of patients who received opioids during their hospital course was significant between block and non-block patients, respectively: bone cyst: 62.7% vs 100% (p<0.001); venous and lymphatic malformation: 65.7% vs 97.4% (p<0.001). Average maximum postanesthesia care unit (PACU) pain scores were significantly lower in bone cyst patients with no significant difference seen in pain scores among venous and lymphatic malformation patients. There were no reported nerve block-related complications.
Discussion: Nerve blocks demonstrated an opioid-sparing effect intraprocedurally and postprocedurally for all subgroups. Their use among bone cyst patients was associated with significant reductions in average maximum PACU pain scores. Nerve blocks may constitute an effective opioid-sparing component of multimodal analgesia in pediatric patients undergoing IR sclerosis procedures. Prospective data are needed to establish the optimal utility of nerve blocks in the IR setting.
背景：神经阻滞在手术室中的作用已被广泛描述，然而，有关介入放射学（IR）治疗室中神经阻滞的证据却很少，也没有对其在儿童中的安全性和有效性进行研究：方法：在一家三级甲等儿童医院进行了一项回顾性研究，以评估神经阻滞在介入放射硬化疗法治疗骨囊肿、静脉畸形和淋巴畸形期间的镇痛作用。淋巴畸形和静脉畸形合并进行最终分析。对2016年1月至2022年9月期间的患者病历进行了审查，以获取手术数据、术后疼痛评分和镇痛剂用药数据：309名患者被纳入最终分析。不同亚组患者术中和术后需要阿片类药物的频率明显降低。阻滞和非阻滞患者在住院期间接受阿片类药物治疗的比例分别为：骨囊肿：62.7% vs 100%（p讨论）：在所有亚组中，神经阻滞在术中和术后都有节省阿片类药物的效果。骨囊肿患者使用神经阻滞可显著降低 PACU 平均最大疼痛评分。在接受红外硬化手术的儿科患者中，神经阻滞可能是多模式镇痛中一种有效的阿片类药物稀释成分。需要前瞻性数据来确定神经阻滞在红外环境中的最佳效用。
期刊介绍：
Regional Anesthesia & Pain Medicine, the official publication of the American Society of Regional Anesthesia and Pain Medicine (ASRA), is a monthly journal that publishes peer-reviewed scientific and clinical studies to advance the understanding and clinical application of regional techniques for surgical anesthesia and postoperative analgesia. Coverage includes intraoperative regional techniques, perioperative pain, chronic pain, obstetric anesthesia, pediatric anesthesia, outcome studies, and complications.
Published for over thirty years, this respected journal also serves as the official publication of the European Society of Regional Anaesthesia and Pain Therapy (ESRA), the Asian and Oceanic Society of Regional Anesthesia (AOSRA), the Latin American Society of Regional Anesthesia (LASRA), the African Society for Regional Anesthesia (AFSRA), and the Academy of Regional Anaesthesia of India (AORA).
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