遗漏外科手术期间的吗啡可以减少手术后的疼痛:一个单中心分析
Fabian Haak1, Fabio Nocera1, Lorena Merlo1
1Clarunis, Department of Visceral Surgery, University Center for Gastrointestinal and Liver Diseases, St. Clara Hospital and University Hospital Basel, Postfach, 4002, Basel, Switzerland.
Updates in surgery
|September 5, 2023
概括
在瘤切除术中省略术前的吗啡显著降低了手术后的疼痛,并使100%的当天出院. 这种方法是安全的,可以减少整体阿片类药物使用,而不会增加并发症.
科学领域:
- 结肠直肠手术 结肠直肠手术
- 麻醉学 麻醉学
- 健行外科手术 健行外科手术
背景情况:
- 门诊手术,包括切除术,正在增加.
- 有效的术后疼痛管理对于成功的门诊手术至关重要.
- 吗啡在术后疼痛控制中的作用需要进一步调查.
研究的目的:
- 为了比较放弃外科手术前的吗啡对手术后疼痛的效果与其对手术后的疼痛的影响.
- 评估吗啡缺失对门诊管理成功率的影响.
- 评估并发症的发生率,包括术后恶心和吐 (PONV) 和尿路保留.
主要方法:
- 一个前性数据库的回顾性分析,比较了接受吗啡 (Yes-Mô) 和不接受吗啡 (No-Mô) 的患者.
- 倾向性得分匹配用于平衡队列.
- 结果包括疼痛评分 (NRS),门诊成功率和并发症率.
主要成果:
- 没有Mô组在术后一个小时报告了明显较低的疼痛评分 (1.44对2.48),p=0.029).
- 在术后24小时内,没有观察到疼痛评分的显著差异 (1.61对1.63,p=0.738).
- 100%的No-Mô组被管理为门诊患者,而Yes-Mô组的这一比例为50% (p<0.001).
- 两组之间没有发现并发症率 (PONV,尿) 的显著差异.
结论:
- 省略外科手术期间的吗啡是一种可行的策略,可以减少瘤切除术后的直接术后疼痛.
- 这种遗漏有助于在不增加并发症的情况下实现更高的当天出院率.
- 减少整体阿片类药物负载可能会减少副作用,并改善门诊直肠外科手术患者的治疗结果.
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