在膝关节关节整形手术期间内科静脉S(+) - 胺的止痛作用:随机对照临床试验的研究方案
Shiyuan Deng1, Lina Chen1, Xiao Song1
1Department of Anesthesiology, The First Affiliated Hospital of Shandong First Medical University, Jinan, China.
JMIR research protocols
|December 8, 2023
概括
这项研究研究了S(+) - 胺在老年人全膝关节整形术 (TKA) 后的疼痛管理. 它旨在确定手术内S(+) - 胺是否有效减少术后疼痛和阿片类药物使用,增强恢复.
科学领域:
- 麻醉学和疼痛管理
- 整形外科手术 整形外科手术
- 老年医学 老年医学
背景情况:
- 膝关节整形术 (TKA) 是对末期膝关节疾病的常见手术,病例显著增加.
- 在TKA之后,中度至重度的术后疼痛会对患者的康复,满意度和结果产生负面影响.
- 多模式止痛是管理TKA相关疼痛的首选方法,旨在减少阿片类药物消费和不良事件.
研究的目的:
- 评估手术内静脉注射S(+) - 胺的疗效和安全性,作为治疗TKA的老年患者急性疼痛缓解的辅助剂.
- 为麻醉科医生提供基于证据的有效早期术后疼痛管理策略.
- 评估低剂量S(+) - 胺在改善TKA后患者结局方面的潜在益处.
主要方法:
- 一个随机的,安慰剂对照试验,涉及144名65岁以上的参与者接受TKA.
- 在手术期间,参与者将接受S(+) - 胺 (0.3 mg/kg/h) 或安慰剂静脉注射.
- 疼痛将在手术后2,24和48小时使用数值评分表进行评估,并与止痛药的消耗和不良事件一起进行评估.
主要成果:
- 该研究协议已注册 (ClinicalTrials.gov NCT05289050) 并遵守机构指南.
- 招聘开始于2022年4月,预计数据收集将在2024年9月结束.
- 该研究预计将于2024年12月完成,结果正在等待.
结论:
- 一项随机对照试验旨在评估外科手术中S(+) - 胺在TKA后的老年患者的止痛作用.
- 该研究将提供关于低剂量S(+) - 胺的有效性和安全性的关键数据,用于管理该群体的急性术后疼痛.
- 这些发现可能支持将S(+) - 胺作为TKA后多模式止痛疗法的有效成分.
相关概念视频
Parenteral Anesthetics: Overview
130
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
130
Local Anesthetics: Clinical Application as Spinal Anesthesia
636
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
636
Local Anesthetics: Clinical Application as Epidural Anesthesia
435
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
435
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
430
Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
One of the advantages of...
430
Local Anesthetics: Pharmacokinetics
764
The potency and duration of action of local anesthetics (LAs) are determined by their pharmacokinetics. Pharmacokinetics describes how LAs are absorbed, distributed, metabolized, and eliminated from the body. When administered to the vascular tissues, LAs are quickly absorbed and enter the systemic circulation, reducing their localized effects. Adding vasoconstrictors such as epinephrine to LAs reduces their absorption into the systemic circulation, making them clinically effective. The...
764
General Anesthesia: Overview
223
Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
223


