静脉注射德克斯梅德托米丁在骨科手术中的阿片类药物缓解效果:回顾性分析
Valerio Donatiello1, Aniello Alfieri2, Andrea Napolitano2
1Department of Elective Surgery, Postoperative Intensive Care Unit and Hyperbaric Oxygen Therapy, A.O.R.N. Antonio Cardarelli, V.le Antonio Cardarelli 9, 80131, Naples, Italy. valerio.donatiello@gmail.com.
Journal of anesthesia, analgesia and critical care
|June 29, 2023
概括
德克斯梅德托米丁显著降低了接受区域麻醉的骨科手术患者对阿片类救援药物的需求. 这种镇静剂和止痛剂增强了局部麻醉效果,并降低了手术后的阿片类药物消耗,而不会增加并发症.
科学领域:
- 麻醉学 麻醉学
- 整形外科手术 整形外科手术
背景情况:
- 德克斯梅德托米丁是一种选择性α-2激动剂,可提供镇静和止痛,副作用最小.
- 它不与GABA受体相互作用,使其与其他镇静剂区别开来.
研究的目的:
- 为了评估德克斯梅德托米丁在静止和术后疼痛控制在骨科手术在局部麻醉下的疗效.
- 在止痛药救援需求和阿片类药物消费方面比较其与米达佐拉姆的作用.
主要方法:
- 对128名骨科手术患者的回顾性分析 (2019年1月至2021年12月).
- 患者接受了标准化的局部麻醉和术后止痛.
- 队列被分为德克斯梅德托米丁 (D组) 和米达佐拉姆 (M组) 镇静组.
主要成果:
- 与M组 (midazolam) 相比,D组 (dexmedetomidine) 的患者避免服用阿片类药物救生剂的患者数量显著增加 (49 vs 11,p < 0.001).
- 德克斯梅托米丁组的阿片类药物的总和平均消费量明显较低,D组的阿片类药物消费量比M组少62.06% (p < 0.001).
- 术后首次阿片类药物给药的时间在两组之间没有显著差异.
结论:
- 持续输注德克斯梅德托米丁可以增强局部麻醉的止痛作用,并减少骨科手术后的阿片类药物需求.
- 德克斯梅德托米丁在没有呼吸抑制的情况下提供有效的镇静和止痛,显示出广泛的安全空间.
- 它的使用与术后并发症的增加率无关.
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