低剂量普雷加巴林在心脏外科手术后改善康复过程中的术后实施:心脏外科手术前后观察性研究
Alopi Patel1, Ami Shah2, Anthony Apigo1
1Department of Anesthesiology, Perioperative and Pain Medicine, Mount Sinai Morningside Medical Center, New York, NY.
Journal of cardiothoracic and vascular anesthesia
|November 8, 2023
概括
低剂量普雷加巴林在心脏手术患者的术后阿片类药物使用量在0.0日显著减少30.6%. 这种增强的恢复方案显示不增加不良事件,但没有影响停留时间或死亡率.
科学领域:
- 麻醉学 麻醉学
- 心脏外科手术 心脏外科手术
- 药理学 药理学是指药理学的学科.
背景情况:
- 心脏手术后增强恢复 (ERAS) 协议旨在优化患者的治疗结果.
- 阿片类药物的使用和疼痛管理是心脏手术恢复的关键组成部分.
- 研究新的药理干预措施以改进ERAS协议至关重要.
研究的目的:
- 为了确定低剂量普雷加巴林对经心脏手术的患者在ERAS协议内外科手术后期结果的影响.
- 评估普雷加巴林对阿片类药物消费,疼痛评分和其他恢复指标的影响.
主要方法:
- 在第三级护理医院进行了一项前后观察性研究.
- 接受非抽冠状动脉旁路移植手术的患者在术后48小时内每天两次服用75毫克普雷加巴林或不服用普雷加巴林.
- 测量的主要结果包括外科手术期间的阿片类药物使用,疼痛评分,停留时间,输出管的时间和死亡率.
主要成果:
- 低剂量的普雷加巴林在术后的第0天显著降低了术后阿片类药物消耗30.6% (p < 0.001).
- 在术后1至4天没有观察到疼痛评分的显著差异,但在0至12小时的普雷加巴林组观察到更高的疼痛 (p=0.013).
- 没有增加不良事件的发生率,也没有显著差异在ICU停留时间,输出管的时间或死亡率.
结论:
- 低剂量的外科手术期间的普雷加巴林有效地减少了ERAS协议内的心脏手术患者的手术后立即使用阿片类药物.
- 普雷加巴林的使用被发现是安全的,并没有显著增加不良事件.
- 需要进一步的随机对照试验来确定最佳的剂量策略,并确认这些发现,重点是限制混因素.
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