无阿片类药物麻醉在胸腔镜肺切除后减少术后恶心和吐:一项随机对照试验
Chang-Dong Feng1, Yu Xu2, Shaomu Chen3
1Department of Anaesthesiology, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China; Institute of Anaesthesiology, Soochow University, Suzhou, Jiangsu, China.
British journal of anaesthesia
|December 2, 2023
概括
无阿片类药物麻醉 (OFA) 在接受肺部手术的患者中显著减少了手术后恶心和吐 (PONV) 的一半. 这种方法为传统的阿片类麻醉提供了一个有希望的替代方案,用于管理PONV.
科学领域:
- 麻醉学 麻醉学
- 外科手术的结果
- 患者的恢复 患者的恢复
背景情况:
- 在手术期间使用阿片类药物与术后恶心和吐 (PONV) 有关.
- 无阿片类药物麻醉 (OFA) 可以减轻PONV发病率.
- 胸腔镜肺切除患者对PONV敏感.
研究的目的:
- 为了比较OFA与基于阿片类药物的麻醉在减少PONV中的有效性.
- 为了评估PONV率在胸腔镜肺切除后的前48小时内.
- 评估OFA在该患者队列中的安全性和次要结果.
主要方法:
- 一项随机对照试验,涉及120名接受胸腔镜肺切除的成年患者.
- 患者被分配给OFA (乙胺,德克斯米德托米丁,塞沃弗卢兰) 或基于阿片类药物的麻醉 (苏夫坦尼尔,塞沃弗卢兰).
- 手术填充指数 (SPI) 指导了手术内止痛;所有患者都接受了PONV预防和多模式止痛.
主要成果:
- OFA显著降低了PONV发病率的50%以上 (15%对31.7%;OR=0.38).
- 需要治疗OFA以预防一个PONV病例的数量是6.
- OFA导致吐率降低,但在麻醉后护理单位 (PACU) 停留时间略长.
结论:
- 由SPI指导的OFA有效地将胸腔镜肺切除后的PONV发病率减半.
- 当使用PONV预防和多模式止痛时,OFA是基于阿片类麻醉的可行的替代方案.
- 虽然对PONV有效,但OFA可能与长时间的PACU停留有关.
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