最佳术后纳尔布芬剂量方案:一项随机对照试验,对拉巴罗镜胆囊切除术患者进行
Guan-Yu Chen1,2, Kung-Kai Kuo3, Shih-Chang Chuang3
1Department of Anesthesiology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
Medicina (Kaunas, Lithuania)
|February 24, 2024
概括
对于腹腔镜胆囊切除术,纳尔布芬剂量为0.1至0.2毫克/千克对于术后疼痛管理是有效的. 较低剂量 (0.05 mg/kg) 可能是合适的,但没有发现满意度或不良事件的显著差异.
科学领域:
- 麻醉学 麻醉学
- 药理学 药理学是指药理学的学科.
- 手术疼痛管理手术疼痛管理
背景情况:
- 最佳的术后止痛疗法旨在有效缓解疼痛,没有不良影响.
- 纳尔布芬,一个局部的mu-opioid对抗剂和kappa-opioid激动剂,是一种潜在的选择,用于管理腹腔镜手术后的疼痛.
- laparoscopic胆囊切除术患者需要有效的疼痛管理策略.
研究的目的:
- 确定适合的纳尔布芬剂量,以控制腹腔镜胆囊切除术患者的手术后疼痛.
- 评估不同纳尔布芬加重剂量 (0.05,0.10和0.20毫克/公斤) 对术后疼痛的疗效和安全性.
- 评估纳尔布芬的消耗,疼痛评分,患者满意度和不良事件.
主要方法:
- 一项随机研究涉及三组接受低 (0.05毫克/公斤),中等 (0.10毫克/公斤) 或高 (0.20毫克/公斤) 的纳布芬充电剂量通过患者控制的止痛药.
- 每个玻尿酸剂量使用7分钟的锁定间隔,没有背景输液.
- 主要结局包括术后疼痛评分和纳尔布芬消费;次要结局是阿片类药物相关的不良事件和患者满意度.
主要成果:
- 与中高剂量组 (p=0.039) 相比,低纳尔布芬剂量组 (0.05 mg/kg) 在手术后的头两个小时内报告了较高的初始疼痛得分.
- 低纳尔布芬剂量组在术后四小时内比其他组消耗的药物少 (p=0.047).
- 在患者满意度得分或剂量组间不良事件发生率方面没有发现显著差异.
结论:
- 纳尔布芬剂量为0.1至0.2毫克/公斤,被认为是适合在腹腔镜胆囊切除术后的前四小时进行初始术后疼痛管理.
- 在这种患者群体中,较低的0.05 mg/kg的纳尔布芬剂量可能是术后疼痛管理的可行选择.
- 该研究建议根据个体患者的需要和疼痛反应,对纳尔布芬剂量采取灵活的方法.
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