待機的低侵襲大腸手術における連続創部浸潤対プラセボ(CIMICS):ランダム化比較試験の試験プロトコル
Sofie Glazemakers1,2, Stijn H J Ketelaers1, Harm J Scholten3
1Department of Surgery, Catharina Hospital, Eindhoven, the Netherlands.
PloS one
|January 21, 2026
まとめ
本研究では、低侵襲大腸手術の術後回復強化外科(ERAS)ケアの一環として、局所麻酔薬による連続創部浸潤(CWI)を評価する。結果は、多角的鎮痛および周術期ガイドラインの強化に役立つ可能性がある。
科学分野:
- 麻酔科学
- 外科的回復
- 疼痛管理
背景:
- 術後回復強化外科(ERAS)プログラムは、オピオイド使用量を減らし、患者のアウトカムを改善するために多角的鎮痛を利用しています。
- 局所麻酔薬による連続創部浸潤(CWI)は、多角的鎮痛の潜在的な追加です。
- ERASプロトコル内での低侵襲手術におけるCWIの有効性は確立されていません。
主な方法:
- 192人の患者を対象とした単一施設、盲検化、ランダム化比較試験。
- 患者は、標準化されたERASケアと並行して、ブピバカインによるCWIまたは生理食塩水によるプラセボCWIのいずれかを受けました。
- 主要評価項目は、術後2日目の回復の質スコア(QoR-15NL)でした。
結論:
- 本試験は、低侵襲でERASに準拠した大腸手術におけるCWIの最初のランダム化比較評価を表します。
- 結果は、エビデンスに基づいた周術期ケアガイドラインに情報を提供し、多角的鎮痛戦略を最適化することが期待されます。
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