超声引导下椎旁阻滞用于腹股沟疝修补术:新斯的明有作用吗?

H. Ali, Naglaa A. Elnegeery
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摘要

背景在椎旁阻滞(PVB)等区域麻醉技术下进行腹股沟修复手术的趋势越来越多。新斯的明已被用作局部麻醉剂的辅助剂,但现有的研究很少。本研究旨在评估新斯的明作为局部麻醉辅助PVB在腹股沟疝修补术中的效果。患者和方法本前瞻性随机研究包括72例准备在PVB下进行选择性腹股沟疝修补术的患者。将其分为两组:新斯的明组给予布比卡因与新斯的明的混合治疗(5 μg/kg),对照组给予单独布比卡因治疗。术后记录疼痛评分、血流动力学参数、首次镇痛要求、总镇痛用量、不良反应发生率。结果两组在年龄和体重方面都有相似的发现。然而,在对照组中,需要抢救性镇痛的患者数量明显增加。此外,控制组报告了较早的首次镇痛请求。双氯芬酸和芬太尼的用量在未使用新斯的明的情况下均有所增加。术后4、6小时新斯的明组疼痛评分明显改善。两组之间的血流动力学参数几乎相当。结论新斯的明是局麻药的有效辅助剂,可显著改善局麻药的镇痛效果。在临床实践中应鼓励使用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Ultrasound-guided paravertebral block for inguinal herniorrhaphy: does neostigmine have a role?
Background There has been an increasing trend toward performing inguinal repair surgeries under regional anesthetic techniques like paravertebral block (PVB). Neostigmine has been used as an adjuvant to local anesthetics, but the existing research studies are few. This study was conducted to evaluate the efficacy of neostigmine as an adjuvant to local anesthesia used for PVB in inguinal hernia repair procedures. Patients and methods This prospective randomized study included 72 patients prepared for elective inguinal hernia repair under PVB. They were allocated into two groups: the neostigmine group received a mixture of bupivacaine and neostigmine (5 μg/kg), whereas the control group received bupivacaine alone. During the postoperative period, pain score, hemodynamic parameters, first analgesic request, total analgesic consumption, and the incidence of adverse effects were noted and recorded. Results Both groups showed comparable findings regarding age and weight. However, the number of patients requiring rescue analgesia showed a significant increase in the control group. Moreover, controls reported significantly earlier first analgesic requests. Both diclofenac and fentanyl consumptions were increased without neostigmine administration. Pain score was significantly better with neostigmine at 4 and 6 h after surgery. Hemodynamic parameters were almost comparable between the two groups. Conclusion Neostigmine appears to be an efficient adjuvant to local anesthetics when administered during PVB as it significantly improves its analgesic profile. Its administration should be encouraged in clinical practice.
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