■大多数心脏手术是通过正中胸骨切开术进行的,其中49%的患者在术后休息时出现剧烈疼痛,高达78%的患者在咳嗽和深呼吸时出现疼痛。针对胸神经根的局部胸壁阻滞可改善镇痛质量并限制阿片类药物的使用。在具有多个管路和导管的患者中,通过后路的截头阻滞通常会很麻烦。肋间筋膜平面阻滞(PIFB)可以是实现可比镇痛的便捷替代方法。
■患者被随机分配接受超声引导下的胸骨肋间筋膜平面阻滞(PIFB)或直立脊柱平面阻滞(ESPB)。结果测量并比较静息和深呼吸2、6、12、24h的术后疼痛评分,术后总阿片类药物(芬太尼)消耗,抢救镇痛时间和所需的总抢救镇痛剂量,两组之间。
■分析了30例患者的数据。发现两组在休息和深呼吸时的术后疼痛评分具有可比性。消耗的阿片类药物总量,两组抢救镇痛时间和抢救镇痛总剂量无统计学差异。
■PIFB在减轻通过胸骨切开术接受心脏手术的患者的术后疼痛方面与ESPB相当。而且it/PIFB可以是后躯干块的更快替代方案,因为它可以安全地以仰卧位使用超声。
UNASSIGNED: Most cardiac surgeries are performed through a median sternotomy, of which 49% of these patients experience severe pain at rest postoperatively and up to 78% on coughing and deep breathing. Regional thoracic wall blocks targeting thoracic nerve roots improve the analgesia quality and limit opioid use. Truncal blocks through the posterior approach can often be cumbersome in patients with multiple lines and catheters. Pecto-Intercostal Fascial Plane Block (PIFB) can be a convenient alternative for achieving comparable analgesia.
UNASSIGNED: The patients were randomly assigned to receive either an ultrasound-guided Pecto-Intercostal Fascial Plane Block (PIFB) or Erector Spinae Plane Block (ESPB). The outcomes measured and compared postoperative pain scores at rest and on deep breathing at 2, 6, 12, 24 h, total opioid (fentanyl) consumption in the postoperative period, time to rescue analgesia and total rescue analgesic doses required, between the two groups.
UNASSIGNED: Data from 30 patients were analysed. Post-operative pain scores at rest and during deep breathing were found to be comparable in both groups. The total opioid consumed, time to rescue analgesia and total doses of rescue analgesia was not found to be statistically different in the two groups.
UNASSIGNED: PIFB was found to be comparable to ESPB in alleviating post-operative pain in patients who underwent cardiac surgeries through sternotomy. And it/PIFB can be a quicker alternative to posterior truncal blocks since it can be safely given in a supine position with an ultrasound.