在整形外科手术后预防术后恶心和吐:一个范围审查
Peng-Fei Gao1, Le Zhao1, Shi-Yue Li1
1State Key Laboratory of Oral Diseases, Department of Anesthesiology, West China Hospital of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, 610041, China.
BMC anesthesiology
|March 28, 2024
概括
在整形外科手术后,术后恶心和吐 (PONV) 的有效预防包括像德克萨米他松和丹塞这样的抗emetics. 带有神经阻塞的多种模式止痛也显示出对PONV预防的希望.
科学领域:
- 麻醉学 麻醉学
- 口腔和牙面部外科手术
- 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) 是骨头骨关节手术后的常见并发症.
- PONV可能导致不良后果,包括出血,延迟愈合和伤口感染.
研究的目的:
- 确定有效的策略,以预防PONV在整形手术患者.
- 审查过去15年的药理和非药理PONV预防方法.
主要方法:
- 我们对PubMed,Cochrane和Embase数据库进行了系统的搜索.
- 包括在2008年至2023年5月期间发表的评估正手术中PONV预防的研究.
- 排除标准包括案例系列,综述,回顾性研究和缺乏特定结果的研究.
主要成果:
- 包括21项研究,检查了各种药理学药物 (例如,翁丹塞,德克萨梅他,德克斯梅托米丁,普雷加巴林) 和非药理学方法 (例如,喉包,胃吸收).
- 周围神经阻塞和某些抗药物在PONV预防中表现出有效性.
- 像喉袋这样的非药物方法显示出有限的疗效和潜在的并发症.
结论:
- 预防性抗emetics如德克萨米他,ondansetron和penehyclidine是对PONV的主要防御.
- 结合神经阻塞和非阿片类止痛药的多式止痛药提供阿片类药物节约和PONV预防的好处.
- 需要进一步的研究,包括未来的RCT,以验证胃吸收在这个患者群体中用于PONV预防.
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