在头皮阻滞下,浅层颈丛神经阻滞对因手术定位而接受开颅钻孔术治疗单侧慢性硬膜下血肿患者颈部疼痛的疗效:前瞻性随机对照试验

Pragya Shukla, Shekhar Anand, Kavita Meena, Rajesh Meena
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引用次数: 0

摘要

:在对老年患者进行毛细孔排空术的多项研究中,已详细讨论了全身麻醉技术的替代方法、手术部位的疼痛处理等问题。这是第一项关于如何处理为进入手术部位而进行颈部极度反外侧旋转所导致的疼痛的研究。 试验:该试验(2021 年 1 月至 2022 年 1 月)在头皮阻滞下对 60 名年龄≥ 18 岁、ASA I/I/III 级的患者进行了单侧毛细孔开颅手术,以清除慢性硬膜下血肿(CSDH)。D组(30 人)在超声引导下接受 5 毫升 0.5% 布比卡因的颈浅神经丛阻滞(SCPB),P 组(30 人)在安慰剂(生理盐水)的作用下接受 SCPB。主要结果是术后颈部活动时的疼痛评分(NRS)。次要指标是用改良阿什沃斯量表(MAS)评估的肌肉痉挛情况、镇痛药的消耗量、改良拉姆塞镇静评分(MRSS)和血液动力学参数:与使用安慰剂的 SCPB 组相比,使用药物(D)的 SCPB 组在 8 小时后的 NRS 评分明显较低(P 值 = 0.019)。在 12 小时前,P 组的 MAS 评分高于 D 组(<0.001)。P 组的镇痛抢救用量高于 D 组(<0.001)。在整个术中期间,D组的MRSS明显高于P组(<0.001):术前浅层颈丛阻滞可减轻术后颈部疼痛并促进颈部旋转。
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 superficial cervical plexus block in the management of neck pain due to surgical positioning in patients undergoing burr-hole craniotomy for unilateral chronic subdural hematoma under scalp block: A prospective randomized control trial
: Alternatives to general anesthesia technique, pain management of surgical sites have been discussed at length in various studies for burr-hole evacuation in geriatric patients. This is the first study addressing the management of pain that occurs due to extreme contra-lateral side neck rotation to access the surgical site. : This trial was conducted (from January 2021 to January 2022) on 60 patients of age ≥ 18 years with ASA grade I/I/III undergoing unilateral burr hole craniotomy for evacuation of chronic subdural hematoma (CSDH) under scalp block. Group D (n=30) received 5 ml of 0.5% bupivacaine by ultrasound-guided superficial cervical plexus block (SCPB), and group P (n=30) received SCPB with placebo (normal saline). The primary outcome was the numerical rating pain score (NRS) pain score during neck movement in the postoperative period. Secondary objectives were muscle spasm assessed by the modified Ashworth scale (MAS), consumption dosage of rescue analgesia, modified Ramsay sedation score (MRSS), and hemodynamic parameters.: NRS scores were significantly lower at 8 hours in the SCPB with drug (D) group compared to the SCPB with placebo group (p-value = 0.019). MAS were higher in group P compared to group D until 12 (<0.001). Consumption of rescue analgesia was higher in group P than group D (<0.001). MRSS was significantly higher in group D compared to group P throughout the intra-operative period (<0.001).: Preoperative superficial cervical plexus block decreases postoperative neck pain and facilitates neck rotation.
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