超声引导直立者脊柱平面阻滞联合右美托咪定治疗腰椎手术术后疼痛的效果:一项基于病例的讨论

F. Coppolino, P. Sansone, Carmela Porfidia, M. Passavanti, V. Pota, L. G. Giaccari, C. Aurilio, M. Pace
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引用次数: 0

摘要

背景超声引导下的直立脊柱平面阻滞(US-ESPB)在腰椎手术术后疼痛管理的多模式入路中是一种简单安全的有效方法。研究表明,多模式麻醉的使用减少了术中和术后阿片类药物的使用,也改善了镇痛效果。越来越多的证据表明,在局部麻醉中辅助使用右美托咪定可以显著延长镇痛时间,增强阻滞效果,且无明显的临床副作用。连续6例患者在腰椎手术后接受双侧超声引导下的直立者脊柱平面阻滞,局部麻醉和右美托咪定作为多模式镇痛治疗的一部分。采用数值评定量表(NRS)和镇痛总获益评分(OBAS)评估治疗的充分性;总的来说,所有患者的观察结果都令人满意。结论双侧US-ESPB有助于腰椎手术后提供足够的术后镇痛。它简单而安全,因此与其他阻塞相比,它是独一无二的。添加右美托咪定作为辅助剂似乎可以提高镇痛效果和持久性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The effect of ultrasound-guided erector spinae plane block combined with dexmedetomidine for postoperative pain management in lumbar spine surgery: A case-based discussion
Background Ultrasound-guided erector spinae plane blocks (US-ESPB) can be valid resources of simple and safe execution in a multimodal approach to postoperative pain management in lumbar spine surgery. It has been shown that the use of multimodal anesthesia reduces the use of intraoperative and postoperative opioids, and also improves analgesia. A growing body of evidence supports that the adjuvant use of dexmedetomidine in locoregional anesthesia significantly prolongs the analgesia and potentiates the effect of the block, without clinically significant side effects. Case presentation A series of six consecutive patients received bilateral ultrasound-guided erector spinae plane blocks with local anesthetics and dexmedetomidine as part of a multimodal analgesic therapy after lumbar spine surgery. Treatment adequacy was evaluated using numerical rating scale (NRS) and overall benefit of analgesic score (OBAS); overall the observed results were satisfactory for all patients. Conclusion Bilateral US-ESPB appears to be helpful in providing adequate postoperative analgesia after lumbar spine surgery. It is simple and safe, and so it is unique when compared to other blockages. The addition of Dexmedetomidine as an adjuvant seems to improve analgesic effectiveness and durability.
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