慢性β抑制剂治疗对外科手术期间阿片类药物消费的影响 - 临时后二次分析
Ralf F Trauzeddel1, Luisa M Rothe2, Michael Nordine3
1Department of Anesthesiology and Intensive Care Medicine, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität and Humboldt Universität zu Berlin, Hindenburgdamm 30, Berlin, 12203, Germany.
BMC anesthesiology
|February 27, 2024
概括
在接受非心脏手术的老年患者中,慢性β-阻断剂 (BB) 治疗没有改变术前阿片类药物需求. 这项研究发现,在BBs和非BBs患者之间,吗啡等效剂量没有显著差异.
科学领域:
- 心脏病学 心脏病学
- 麻醉学 麻醉学
- 药理学 药理学是指药理学的学科.
背景情况:
- 贝塔抑制剂 (BB) 治疗对于心血管疾病管理至关重要.
- 在心血管疾病患者的非心脏手术期间,阿片类药物是麻醉的组成部分.
- 慢性BB治疗对外科手术期间阿片类药物需求的影响尚不清楚.
研究的目的:
- 调查慢性BB治疗是否会影响外科手术期间的阿片类药物需求.
- 基于BB使用,分析接受非心脏手术的老年患者的阿片类药物消耗.
主要方法:
- 从多中心观测BioCog研究中对前性收集的数据进行了后期分析.
- 包括接受选择性非心脏手术的老年患者 (≥65岁) 与全静脉全麻醉.
- 使用多重回归分析,比较慢性BBs和非BBs患者之间的阿片类药物消费 (吗啡等效剂量),使用多重回归分析.
主要成果:
- 总共分析了106名患者,其中37人患有慢性BBS.
- 接受BB治疗的患者患高血压和功能衰竭等并发病率较高.
- 在BB和非BB组之间没有观察到累积的外科手术前吗啡等效剂量的显著差异.
结论:
- 慢性BB治疗与手术前期阿片类药物消耗的减少无关.
- 老年,男性性别和更长的麻醉时间最初是增加阿片类药物使用的预测因素,但在精细的模型中,只有女性性别和麻醉时间仍然是重要的预测因素.
相关概念视频
Adrenergic Antagonists: Pharmacological Actions of β-Receptor Blockers
801
β-receptor blockers significantly impact the cardiovascular system by counteracting catecholamine-induced sympathetic responses. These medications decrease heart rate, contractility, and cardiac output, potentially leading to cardiac depression, life-threatening bradycardia, and death. Therapeutically, β-blockers function as mild antihypertensives and are utilized in treating angina pectoris and cardiac arrhythmias. However, nonselective β-blockers inhibit β2-receptors in...
801
Opioid Analgesics: Synthetic and Semisynthetic Opioids
295
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...
295
Analgesia and Pain Management
618
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...
618
Heart Failure Drugs: β-Blockers
338
β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation,...
338
Adrenergic Antagonists: ɑ and β-Receptor Blockers
447
Third-generation β-blockers, such as labetalol and carvedilol, represent a significant advancement in managing cardiovascular conditions. Unlike conventional β-blockers, which can induce peripheral vasoconstriction, third-generation drugs block α1 adrenoceptors. This promotes vasodilation through several mechanisms, such as increased nitric oxide production, inhibition of calcium ion entry, opening of potassium ion channels, and antioxidant action. Labetalol, for instance, is...
447
Opioid Analgesics: Morphine and Other Natural Cogeners
249
Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
249


