胸椎旁阻滞联合静脉注射右美托咪定在医学胸腔镜中的疗效:一项随机对照试验

A. Maaly, A. Abdelhady, Rehab Abdelaziz
{"title":"胸椎旁阻滞联合静脉注射右美托咪定在医学胸腔镜中的疗效:一项随机对照试验","authors":"A. Maaly, A. Abdelhady, Rehab Abdelaziz","doi":"10.4103/roaic.roaic_78_20","DOIUrl":null,"url":null,"abstract":"Background Medical thoracoscopy has become the gold standard for evaluation of intrapleural space. Thoracic paravertebral block is instillation of local anesthetic drug in the thoracic paravertebral space and can be used in several procedures such as medical thoracoscopy. Dexmedetomidine is a potent α-2 agonist with a higher potency and short duration of action. It has a rapid onset and offset. It produces an ‘interactive’ form of sedation and does not induce respiratory depression. This study was conducted to evaluate the efficacy of paravertebral block with intravenous (i.v.) infusion of dexmedetomidine compared with standardized general anesthesia method in medical thoracoscopy. Patients and methods A randomized controlled trial was conducted in the Department of Chest Diseases at Alexandria Main University Hospital, on patients indicated for medical thoracoscopy. Patients were randomized into two groups (30 patients each). Group A received general anesthesia. Group B received paravertebral block at the level of medical thoracotomy covering three levels: at, above, and below thoracotomy level plus i.v. dexmedetomidine. Demographic data, hemodynamics, patient-rated procedural pain, and operator-rated overall procedure satisfaction scores were recorded. Results A significantly lower means of heart rate and blood pressure were found in group B after thoracotomy and immediately postoperative. Patient-rated procedural pain score in group A ranged from 2 to 5 with a mean of 3.90±0.85, while in group B, it ranged from 0 to 3 with a mean of 1.40±0.68. This difference was statistically significant (P<0.001). A significantly higher operator-rated overall procedure satisfaction score was found in group B (95.77±1.74) compared with group A (90.03±2.33) (P<0.001). Conclusion Use of thoracic paravertebral block plus use of i.v. dexmedetomidine in medical thoracoscopy is comparable to general anesthesia as it is comfortable to the patient and the operator without dealing with airway and its difficulties.","PeriodicalId":151256,"journal":{"name":"Research and Opinion in Anesthesia and Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Efficacy of combined thoracic paravertebral block and intravenous dexmedetomidine in medical thoracoscopy: a randomized controlled trial\",\"authors\":\"A. Maaly, A. Abdelhady, Rehab Abdelaziz\",\"doi\":\"10.4103/roaic.roaic_78_20\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background Medical thoracoscopy has become the gold standard for evaluation of intrapleural space. Thoracic paravertebral block is instillation of local anesthetic drug in the thoracic paravertebral space and can be used in several procedures such as medical thoracoscopy. Dexmedetomidine is a potent α-2 agonist with a higher potency and short duration of action. It has a rapid onset and offset. It produces an ‘interactive’ form of sedation and does not induce respiratory depression. This study was conducted to evaluate the efficacy of paravertebral block with intravenous (i.v.) infusion of dexmedetomidine compared with standardized general anesthesia method in medical thoracoscopy. Patients and methods A randomized controlled trial was conducted in the Department of Chest Diseases at Alexandria Main University Hospital, on patients indicated for medical thoracoscopy. Patients were randomized into two groups (30 patients each). Group A received general anesthesia. Group B received paravertebral block at the level of medical thoracotomy covering three levels: at, above, and below thoracotomy level plus i.v. dexmedetomidine. Demographic data, hemodynamics, patient-rated procedural pain, and operator-rated overall procedure satisfaction scores were recorded. Results A significantly lower means of heart rate and blood pressure were found in group B after thoracotomy and immediately postoperative. Patient-rated procedural pain score in group A ranged from 2 to 5 with a mean of 3.90±0.85, while in group B, it ranged from 0 to 3 with a mean of 1.40±0.68. This difference was statistically significant (P<0.001). A significantly higher operator-rated overall procedure satisfaction score was found in group B (95.77±1.74) compared with group A (90.03±2.33) (P<0.001). Conclusion Use of thoracic paravertebral block plus use of i.v. dexmedetomidine in medical thoracoscopy is comparable to general anesthesia as it is comfortable to the patient and the operator without dealing with airway and its difficulties.\",\"PeriodicalId\":151256,\"journal\":{\"name\":\"Research and Opinion in Anesthesia and Intensive Care\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2022-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Research and Opinion in Anesthesia and Intensive Care\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4103/roaic.roaic_78_20\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Research and Opinion in Anesthesia and Intensive Care","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4103/roaic.roaic_78_20","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

摘要

背景医学胸腔镜已成为评价胸膜内腔的金标准。胸椎旁阻滞是在胸椎旁间隙内注入局麻药,可用于医学胸腔镜等多种手术。右美托咪定是一种强效α-2激动剂,效力高,作用时间短。它有一个快速的开始和抵消。它产生一种“互动”形式的镇静,不会引起呼吸抑制。本研究旨在评价右美托咪定椎旁阻滞静脉输注与标准化全麻方法在内科胸腔镜手术中的疗效。患者和方法在亚历山大大学附属医院胸科进行了一项随机对照试验,研究对象是需要进行内科胸腔镜检查的患者。患者随机分为两组(每组30例)。A组给予全身麻醉。B组采用医用开胸水平椎旁阻滞,覆盖开胸水平、开胸水平以上、开胸水平以下3个水平,同时静脉注射右美托咪定。记录了人口统计数据、血流动力学、患者评价的手术疼痛和手术者评价的总体手术满意度得分。结果B组患者开胸后及术后立即心率、血压均明显降低。A组手术疼痛评分为2 ~ 5分,平均为3.90±0.85分;B组手术疼痛评分为0 ~ 3分,平均为1.40±0.68分。差异有统计学意义(P<0.001)。B组总体手术满意度评分(95.77±1.74)明显高于A组(90.03±2.33)(P<0.001)。结论胸腔镜下椎旁阻滞加右美托咪定静脉滴注与全麻相当,患者和操作者均感到舒适,无需处理气道及其困难。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Efficacy of combined thoracic paravertebral block and intravenous dexmedetomidine in medical thoracoscopy: a randomized controlled trial
Background Medical thoracoscopy has become the gold standard for evaluation of intrapleural space. Thoracic paravertebral block is instillation of local anesthetic drug in the thoracic paravertebral space and can be used in several procedures such as medical thoracoscopy. Dexmedetomidine is a potent α-2 agonist with a higher potency and short duration of action. It has a rapid onset and offset. It produces an ‘interactive’ form of sedation and does not induce respiratory depression. This study was conducted to evaluate the efficacy of paravertebral block with intravenous (i.v.) infusion of dexmedetomidine compared with standardized general anesthesia method in medical thoracoscopy. Patients and methods A randomized controlled trial was conducted in the Department of Chest Diseases at Alexandria Main University Hospital, on patients indicated for medical thoracoscopy. Patients were randomized into two groups (30 patients each). Group A received general anesthesia. Group B received paravertebral block at the level of medical thoracotomy covering three levels: at, above, and below thoracotomy level plus i.v. dexmedetomidine. Demographic data, hemodynamics, patient-rated procedural pain, and operator-rated overall procedure satisfaction scores were recorded. Results A significantly lower means of heart rate and blood pressure were found in group B after thoracotomy and immediately postoperative. Patient-rated procedural pain score in group A ranged from 2 to 5 with a mean of 3.90±0.85, while in group B, it ranged from 0 to 3 with a mean of 1.40±0.68. This difference was statistically significant (P<0.001). A significantly higher operator-rated overall procedure satisfaction score was found in group B (95.77±1.74) compared with group A (90.03±2.33) (P<0.001). Conclusion Use of thoracic paravertebral block plus use of i.v. dexmedetomidine in medical thoracoscopy is comparable to general anesthesia as it is comfortable to the patient and the operator without dealing with airway and its difficulties.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信