对手术后恶心和吐发生的患者控制的疼痛缓解的效果在接受微血管减压的患者中:一个潜在的随机对照试验
Chang-Hoon Koo1,2, So Young Ji3,4, Jung Ho Han3,4
1Departments of1Anesthesiology & Pain Medicine and.
Journal of neurosurgery
|February 9, 2024
概括
与基于芬太尼的PCA相比,基于Ketorolac的患者控制止痛 (PCA) 显著降低了微血管减压 (MVD) 后的术后恶心和吐 (PONV) 发生率和严重程度. 这两种方法都提供了类似的缓解疼痛,这表明洛拉克是PONV管理的可行替代品.
科学领域:
- 麻醉学 麻醉学
- 神经外科 神经外科
- 药理学 药理学是指药理学的学科.
背景情况:
- 手术后恶心和吐 (PONV) 是微血管减压 (MVD) 后的一个常见并发症.
- 芬太尼是一种阿片类药物,与PONV风险增加有关.
- 凯托洛拉克是一种非类固醇抗炎药物 (NSAID),用于治疗疼痛,但其对PONV后MVD的影响尚未得到充分证实.
研究的目的:
- 为了比较PONV在MVD后的基托洛拉克基和芬太尼基患者控制止痛 (PCA) 之间的发病率和严重程度.
- 评估基托洛拉克基PCA与芬太尼基PCA的止痛效果和患者满意度.
主要方法:
- 一项前性,双盲,随机对照试验,涉及87名接受MVD的患者.
- 患者被随机分配,接受基托洛拉克或芬太尼基PCA.
- 在48小时内评估了PONV发病率,严重程度,抗药需求,疼痛得分和满意度.
主要成果:
- 与芬太尼基PCA (p=0.003和p=0.004,分别) 相比,基托洛拉克基PCA的PONV发病率 (48.8%vs79.5%) 和严重程度显著降低 (p=0.003).
- 在基托洛拉克组 (p=0.049) 中,救援抗药的需求减少了.
- 两组之间没有观察到术后疼痛得分的显著差异,但基托洛拉克治疗中断的次数较少 (p=0.001).
结论:
- 与基于芬太尼的PCA相比,基托洛拉克的PCA有效地降低了MVD后的PONV发病率和严重程度.
- 基托洛拉克基PCA提供与芬太尼基PCA相比较的止痛作用.
- 基托洛拉克基的PCA为MVD患者的术后疼痛和PONV管理提供了一个有希望的替代方案.
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