静脉注射布托尔法与特拉马多尔用于脊柱后麻醉的比较:元分析和系统审查
Ji-Xiang Wan1, Xue-Chao Li1, Si-Si Zeng1
1Department of Anesthesiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China.
Frontiers in medicine
|December 20, 2023
概括
布托尔法诺比特拉马多尔更有效地治疗脊髓麻醉后的,提供更快的停止和在一分钟内更高的成功率. 然而,与特拉马多尔相比,布托尔法醇也会导致镇静的增加.
科学领域:
- 麻醉学 麻醉学
- 药理学 药理学是指药理学的学科.
- 临床试验 临床试验
背景情况:
- 脊柱后麻醉是患者常见的并发症.
- 静脉注射布托尔法和特拉马多尔经常被比较用于控制这种副作用.
- 进行了元分析和系统审查,以评估它们的比较疗效和安全性.
研究的目的:
- 为了比较Butorphanol与Tramadol在治疗脊髓麻醉后发的疗效.
- 在这种情况下,评估和比较Butorphanol和Tramadol的副作用概况.
主要方法:
- 随机对照试验 (RCT) 的系统审查和元分析.
- 在PubMed,Cochrane图书馆和Embase数据库中搜索到2022年12月30日.
- 包括5项与302名成年患者进行的RCT;数据使用Review Manager 5.4.4进行分析.
主要成果:
- 布托尔法醇显示,停止发的时间明显较短 (SMD = -0.53,P=0.004).
- 布托尔法醇在1分钟内停止发的比率更高 (RR = 1.69,P = 0.008).
- 观察到,使用布托尔醇时,镇静的发生率更高 (RR = 2.98,P<0.00001).
结论:
- 与特拉马多尔相比,丁醇在控制脊柱后麻醉发方面具有更快的发作和更高的疗效.
- 布托尔法醇被认为优于特拉马多尔,用于治疗脊髓麻醉后的,尽管镇静作用增加.
相关概念视频
Opioid Analgesics: Synthetic and Semisynthetic Opioids
302
Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
302
Parenteral Anesthetics: Overview
129
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.
129
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
434
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...
434
Analgesia and Pain Management
628
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
628
Skeletal Muscle Relaxants: Therapeutic Uses
487
Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx...
487


