胸腔镜手术后的一种新的阿片类药物节约性止痛:一个非劣势试验
Jing-Jing Sun1, Xiao-Bing Xiang2, Guang-Hong Xu1
1Department of Anesthesiology, The First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China.
Drug design, development and therapy
|June 12, 2023
概括
用德克斯梅托米丁修改的肋间间神经阻塞 (MINB) 在胸腔镜手术后提供安全的,节省阿片类药物的止痛疗法. 这种方法减少了第一次浮的时间,而不会影响缓解疼痛.
科学领域:
- 麻醉学 麻醉学
- 胸部外科手术 胸部外科手术
- 疼痛管理 疼痛管理
背景情况:
- 胸腔镜手术后的术后疼痛管理通常依赖于阿片类药物.
- 阿片类药物可能会引起副作用,包括胃肠功能延迟.
- 探索阿片类药物节约技术对于改善患者康复至关重要.
研究的目的:
- 评估使用改性肋间神经阻塞 (MINB) 的阿片类药物节约性止痛的可行性.
- 为了比较基于德克斯梅托米丁的患者控制的静脉静脉止痛 (PCIA) 与经过胸腔镜手术后的传统sufentanil PCIA.
主要方法:
- 一个随机的,非劣势性研究,涉及60名接受单端口胸腔镜叶切除术的患者.
- 在这两组中都进行了MINB,随后进行了达克塞梅托米丁PCIA (干预) 或苏芬坦尼尔PCIA (控制) 72小时.
- 主要结局:视觉模拟尺度 (VAS) 咳24小时;次要结局:时间到第一次止痛要求,PCIA压力,时间到第一次浮,住院.
主要成果:
- 两组之间24小时咳VAS没有显著差异 (P=0.36).
- 与第一次止痛要求相似的时间,PCIA压力时间和组之间的住院时间 (P>0.05).
- 在德克斯梅托米丁组中,第一次浮的时间显著缩短 (P<0.01).
结论:
- 使用MINB和德克斯梅德托米丁的阿片类药物缓解疼痛可以与sufentanil提供可比的缓解疼痛.
- 这种方法通过加速胃肠道恢复提供了潜在的好处.
- 基于MINB的阿片类药物缓解疼痛可能是胸腔镜手术的有价值的替代方案.
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