直肠膜导管可以减少胰腺二管切除术中阿片类药物的使用:干预前后的队列研究
Patrick L C Tapley1, Martin Van der Vyver1, Natalie G Coburn1
1Department of Anaesthesia, Sunnybrook Health Sciences Centre, University of Toronto (Tapley [during the conduct of the study], Van der Vyver); Department of Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont. (Coburn, Hallet, Law, Roke, Karanicolas); University Hospital Southampton NHS Foundation Trust, Southampton, UK (Tapley).
概括
直肠膜导管 (RSCs) 在接受胰腺双管切除术的患者中显著降低了术后的阿片类药物消耗. 这种节制阿片类药物的技术提供了一种有效的替代方案,用于管理大腹部手术后的疼痛.
科学领域:
- 外科手术 手术手术
- 麻醉学 麻醉学
- 疼痛管理 疼痛管理
背景情况:
- 胰腺双管切除术是胰腺癌的唯一治疗方法.
- 在手术后,术后疼痛管理仍然是一个重大挑战.
- 人们越来越需要有效的,节省阿片类药物的止痛替代品来代替外周术技术.
研究的目的:
- 评估直肠膜导管 (RSCs) 的片缓解和止痛作用.
- 在接受胰腺双管切除术的患者中,将RSC与标准护理 (阿片止痛) 进行比较.
主要方法:
- 一项回顾性队列研究比较了胰腺二切除术后RSC和没有RSC的患者.
- 数据是从2018年4月到2019年12月在高等学术医院收集的.
- 术后的阿片类药物总摄入量 (口服吗啡等价物) 和疼痛评分是主要的结局指标.
主要成果:
- 与对照组 (中位数为242.4毫克) 相比,RSC患者在术后96小时消耗的阿片类药物显著减少 (中位数为188毫克) (p=0.01).
- 在RSC组中,从24小时开始观察到减少了阿片类药物的使用.
- 两组之间没有注意到疼痛评分或导管相关并发症的显著差异.
结论:
- 直肠膜导管与术后阿片类药物消费的显著减少有关.
- RSCs是胰腺管切除术多模式止痛的安全和有效组成部分.
- 建议通过大规模随机对照试验进行进一步调查.
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