ラパロスコピー後の静脈内鎮痛における異なるヒドロモルフォンボルス用量の比較: ランダム化制御試験
Xinlong Li1, Minjun Liu1, Gang Chen1
1Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, No. 3 Qingchun East Road, Shangcheng District, Hangzhou, Zhejiang Province, China.
BMC anesthesiology
|August 26, 2025
まとめ
患者のコントロールによる静脈内鎮痛 (PCIA) による異なるヒドロモルフォン投与は,腹腔鏡手術後の同様の痛み緩和を示した. 0. 25mgの投与量は,痛みの緩和と副作用の減少のバランスを最も良く提供しました.
科学分野:
- 麻酔科
- 薬理学について
- 手術による回復
背景:
- 効果的な術後の痛みの管理は,腹腔鏡手術後の患者の回復に不可欠です.
- ヒドロモルフォンなどのオピオイドによる患者制御の静脈内鎮痛 (PCIA) は,手術後の痛みの管理のための一般的な方法である.
- PCIAにおけるヒドロモルフォン投与量を最適化することは,鎮痛と有害事象のバランスをとるために不可欠です.
研究 の 目的:
- PCIA経由で投与された様々なボルス用量 (0. 20 mg, 0. 25 mg, 0. 30 mg) の鎮痛効果と安全性を比較する.
- 痛みのスコア,回復指数,および腹腔鏡手術を受けた患者の有害事象に対する異なるヒドロモルフォン用薬の影響を評価する.
主な方法:
- 腹腔鏡手術を受けた111人の患者を対象としたランダム化試験です.
- ヒドロモルフォンPCIAを背景輸液なしで投与した患者は,0. 20 mg,0. 25 mg,または0. 30 mgのボラス投与量に基づいて3つのグループに分けられました.
- 主なエンドポイントは,手術後24時間の視覚アナログスケール (VAS) による痛みスコアであり,次要アウトカムには,他の時間点での痛み,消費,回復,および有害事象が含まれていました.
主要な成果:
- VASの痛みのスコアは,いずれの時点でも,グループ間で有意な差異は見られなかった.
- 他のグループと比較して,0. 20mgのグループはかなり多くのボラス投与を必要とした.
- 吐き気,嘔吐,めまいなどの有害事象の発生率が最も低い傾向を示し,呼吸抑制は報告されなかった.
結論:
- ハイドロモルフォンPCIAは0. 20 mg,0. 25 mgおよび0. 30 mgのボラス投与で,腹腔鏡手術後の同等の鎮痛効果を提供します.
- ヒドロモルフォン0. 25mgは,効果的疼痛緩和と好ましい安全性プロフィールとの最適なバランスを提供し,有害事象が少ないことが特徴です.
- 0. 20mgの投与量では,より高いボルス頻度が認められ,この低用量では患者のコントロールによる鎮痛が潜在的により低効率であることが示された.
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