外科手术期间外围注射的诺尔上腺素的不良事件:一个前性的多中心研究
Jens Christensen1,2, Elisabeth Andersson1,2, Fredric Sjöberg1,2
1From the Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
在外科手术期间,对外围上腺素的给予显示出2.3%的外流率. 定期对输液部位进行检查,及时改变输液部位,可以预防严重的不良事件,如组织死,这表明采取安全的方法.
科学领域:
- 麻醉学和重症监护医学
- 药理学和治疗学 药理学和治疗学
背景情况:
- 在外科手术期间对低血压进行周围静脉注射的诺亚上腺素有不良事件的风险,包括组织亡.
- 术后期这些不良事件的实际发生率和严重程度尚未得到充分确立.
研究的目的:
- 为了前性地评估与外科手术期间的周围偏上腺素给药相关的不良事件的发生率和严重程度.
- 为了确定治疗期间发生不良事件的危险因素.
主要方法:
- 一项前性观察性研究,涉及1004名在瑞典3家医院 (2019-2022) 接受外科外围上腺素的患者.
- 定期检查输液部位,并立即改变注射部位的胀或白的迹象.
- 监测血压和脉率,将不良事件定义为静脉血压>220毫米升或脉<40次/分钟.
主要成果:
- 扩散的患病率为2.3% (95% CI,1.4%-3.2%),而心发生在0.9% (95% CI,0.4%-1.7%).
- 没有观察到组织亡或严重高血压的病例.
- 靠近导管的放置与不良事件的风险增加有关. 所有事件在48小时内自发消失.
结论:
- 在外科手术期间,外周给药的诺阿皮内林导致外流率与重症患者的外流率相当.
- 积极主动的方法,包括定期检查输液点和及时重新定位,有效地减轻了严重的不良事件.
- 虽然这种预防策略似乎是安全的,但在更大的患者队伍中进一步验证是有必要的,以确认其益处.
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