德克斯梅德托米丁用于非输管视频辅助胸腔镜手术后增强康复
Ting-Fang Kuo1, Man-Ling Wang2, Hsao-Hsun Hsu3
1Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, No. 7, Zhongshan S. Rd., Zhongzheng Dist., Taipei City, 100225, Taiwan, ROC.
Journal of the Formosan Medical Association = Taiwan yi zhi
|February 2, 2024
概括
在非输入管的胸腔镜手术中,添加德克斯梅托米丁在麻醉中减少了阿片类药物的使用和住院时间. 这种阿片类药物节约剂似乎是安全有效的,用于增强微创手术后患者的康复.
科学领域:
- 胸部外科手术 胸部外科手术
- 麻醉学 麻醉学
- 最少侵入性的手术
背景情况:
- 非输入式视频辅助胸腔镜手术 (VATS) 使用最少的侵入性技术和多模式止痛疗法来增强恢复.
- 对于非输入管的VATS,标准镇静方案主要涉及普罗波和芬太尼.
- 德克斯梅德托米丁因其阿片类药物节约性质和最小的呼吸抑制而具有潜在的益处,使其适合于非输入式麻醉.
研究的目的:
- 评估德克斯梅德托米丁在非直管的VATS期间作为普罗波福和芬太尼的辅助剂的疗效.
- 为了比较接受德克斯梅德托米丁和接受标准普罗波福-芬坦尼尔镇静治疗的患者之间的临床结果.
主要方法:
- 在2015年6月至2017年9月期间,对114名接受非输管VATS的患者进行了回顾性分析.
- 倾向性得分匹配分析比较了34名接受德克塞梅托米丁,普罗波和芬太尼的患者与34名接受普罗波和芬太尼的对照组.
- 评估的临床结果包括阿片类药物消费,停留时间和手术内/术后并发症.
主要成果:
- 德克斯梅德托米丁组在术后0天显著降低了阿片类药物消费 (P=0.001) 和术后停留时间更短 (P=0.006).
- 在德克斯梅德托米丁组中,更高比例的患者在手术期间需要血管压缩剂 (P=0.01).
- 两组之间没有观察到低血压,心,短期发病率或死亡率的显著差异.
结论:
- 辅助剂德克斯梅德托米丁在与普罗波福和芬太尼结合使用时,对于非输管的VATS是安全的和可行的.
- 德克斯梅德托米丁的阿片类药物节约作用和缩短术后住院时间的能力表明,它可以增强非输入式胸腔镜手术后的康复.
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