在选择性腹部手术中抑制外科手术期间的应激反应:德克斯美德托米丁和外周阻塞之间的随机比较
Rashmi Salhotra1, Vishal Kamal1, Asha Tyagi1
1Department of Anaesthesiology, Critical Care and Pain Medicine, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India.
除外注射布皮瓦卡因有效抑制了外科手术应激反应,降低了皮质醇和葡萄糖水平,与德克斯梅德托米丁相比. 外周麻醉也提供了更长的缓解腹部手术后的疼痛.
科学领域:
- 麻醉学 麻醉学
- 手术应激反应手术应激反应
- 神经内分泌学神经内分泌学
背景情况:
- 手术会引发一种涉及炎症的压力反应.
- 没有控制的应激反应可能是有害的.
- 针对神经通路可以减轻手术压力.
研究的目的:
- 为了比较外周注射布皮瓦卡因与静脉注射德克斯梅德托米丁在减轻腹部手术的神经内分泌和代谢应激反应方面的疗效.
- 评估血液动力学稳定性和术后止痛药的要求.
主要方法:
- 50名接受选择性腹部手术的成年患者被随机分类.
- 组E接受了 epidural bupivacaine;组D接受了dexmedetomidine,两者都在全身麻醉下进行.
- 测量了血清皮质醇,葡萄糖,尿素,血液动力学和止痛药的消耗.
主要成果:
- 外周注射布皮瓦卡因 (E组) 显著降低了手术后24小时的血清皮质醇水平,与德克斯梅德托米丁 (D组) 相比.
- 组E显示了较低的手术内和手术后葡萄糖水平.
- 患者接受外注布皮瓦卡因需要他们的第一个救援止痛药显著晚些时候.
结论:
- 除外注射布皮瓦卡因在抑制腹部手术的神经内分泌和代谢反应方面比静脉注射德克斯梅德托米丁更有效.
- 在有害刺激和术后期间,德克斯梅德托米丁提供了更好的血液动力学稳定性.
- 外周麻醉提供了优越的抑制手术压力标志物.
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