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首页> 外文期刊>Acta anaesthesiologica Taiwanica : >Opioid consumption after levobupivacaine scalp nerve block for craniosynostosis surgery
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Opioid consumption after levobupivacaine scalp nerve block for craniosynostosis surgery

机译：左旋布比卡因头皮神经阻滞后阿片类药物的颅内融合手术

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Background and objectives: Craniosynostosis surgery is considered a very painful procedure due to extended scalp and periosteal detachment, and is associated with prolonged postoperative consumption of opioids and their side effects. In this observational descriptive case series study, we investigated perioperative opioid consumption in children undergoing craniosynostosis repair under general anesthesia when scalp nerve block with levobupivacaine was involved. Methods: After standard anesthesia induction, scalp nerve block with levobupivacaine 2 mg/kg plus epinephrine 1:800,000 was performed. Hemodynamic parameters and opioid consumption were noted. Patients were monitored in the recovery room. Requirements of additional analgesia, indicated by the Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) pain score of >9, and incidence of side effects (sedation, nausea, and vomiting) were recorded during the first 24 hours. Results: A total of 32 patients were recruited in this study; 88% of them needed morphine rescue in the recovery room because they had high CHEOPS scores. Trigonocephaly was the most frequent type of craniosynostosis (37.5%), requiring 50% more opioids in the postoperative period than other forms of craniosynostosis. Conclusion: Scalp nerve block can be proposed as a complement to the routine craniosynostosis anesthetic protocol, because it is easy to perform, seems to reduce the need for supplementary opioids during the perioperative period, and can reduce the risk of developing acute opioid tolerance and chronic pain. In the event of trigonocephaly or craniofacial reconstruction, a complementary infraorbital nerve block can be added.
机译：背景与目的：由于头皮延长和骨膜分离，颅突吻合术被认为是非常痛苦的手术，并且与术后阿片类药物的长期服用及其副作用有关。在这个观察性描述性病例系列研究中，我们调查了在全身麻醉下头皮神经阻滞与左旋布比卡因联合使用的情况下，接受颅骨突触固定术修复的儿童的围手术期使用阿片类药物的情况。方法：标准麻醉诱导后，以左旋布比卡因2 mg / kg加肾上腺素1：800,000进行头皮神经阻滞。记录血流动力学参数和阿片类药物消耗。在恢复室对患者进行监测。在最初的24小时内，记录了额外的镇痛要求，该疼痛要求由东部安大略省儿童医院儿童疼痛量表（CHEOPS）的疼痛评分大于9表示，并且发生副作用（镇静，恶心和呕吐）。结果：本研究共招募32例患者;他们中有88％的人具有较高的CHEOPS分数，因此需要在康复室进行吗啡抢救。三角头畸形是最常见的颅骨融合症类型（37.5％），与其他形式的颅骨融合症相比，术后期需要的阿片类药物多50％。结论：头皮神经阻滞可以作为常规颅骨鼻窦炎麻醉方案的补充，因为它易于执行，似乎可以减少围手术期对补充阿片类药物的需求，并可以降低出现急性阿片类药物耐受性和慢性阿片类药物的风险。疼痛。如果发生三角头畸形或颅面重建，可以添加眶下神经阻滞。

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