在剖腹产时,单剂量外周用德克斯梅德托米丁与罗皮瓦卡因结合的效果
Minghao Liu1, Xuezi Chen2, Dan Guo3,4
1Department of Anesthesiology, Chengdu Fifth People's Hospital (The Second Clinical Medical College, Geriatric Diseases Institute of Chengdu/Cancer Prevention and Treatment Institute of Chengdu, Affiliated Fifth People's Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, China.
BMC anesthesiology
|April 8, 2024
概括
在剖腹产时添加外周式德克斯梅德托米丁与罗皮瓦卡因,略有改善了疼痛缓解和镇静作用. 这种组合并没有对母婴结合产生负面影响或增加副作用,这表明未来研究中可能需要更高的剂量.
科学领域:
- 麻醉学 麻醉学
- 药理学 药理学是指药理学的学科.
背景情况:
- 德克斯梅德米丁表现出兴奋,镇静和止痛的特性.
- 外周麻醉 (EA) 通常用于剖腹产.
- 在剖腹产期间优化疼痛管理和患者体验至关重要.
研究的目的:
- 为了研究单剂量0.5μg/kg外周脱梅德托米丁与罗皮瓦卡因结合在经过剖腹产的分娩妇女的作用.
- 评估对手术内疼痛评分和镇静水平的影响.
主要方法:
- 这是一项随机对照试验,涉及92名分娩者.
- 参与者被分为两组:单独使用罗皮瓦卡因 (R组) 和罗皮瓦卡因与0.5微克/千克外周 dexmedetomidine (RD组).
- 主要结局包括手术内数值评分表 (NRS) 疼痛评分和兰赛镇静量表 (RSS).
主要成果:
- 与R组相比,RD组在所有时间点 (P > 0.05) 显示NRS疼痛得分明显较低.
- 组RD表现出显著更高的兰赛镇静度量 (P < 0.001).
- 两组之间没有观察到低血压,心,恶心/吐,Apgar分数或整体麻醉满意度的显著差异.
结论:
- 当与罗皮瓦卡因结合用于剖腹产时, epidural dexmedetomidine (0.5μg/kg) 提供了适度的止痛效果.
- 经测试的外周脱梅德米丁剂量并没有影响母亲和婴儿之间的联系,也没有显著改善患者的满意度.
- 没有额外的副作用表明,在未来的研究中,有可能探索更高的德克斯梅德米丁剂量.
相关概念视频
Local Anesthetics: Clinical Application as Epidural Anesthesia
430
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
430
Parenteral Anesthetics: Overview
119
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
119
Local Anesthetics: Clinical Application as Spinal Anesthesia
623
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
623
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
408
Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
One of the advantages of...
408
Depolarizing Blockers: Pharmocokinetics
324
Depolarizing blockers are administered through intravenous injection. Succinylcholine is the most common choice of depolarizing blockers in emergency clinical practices. Although they have a rapid onset, they readily diffuse away from the motor end plate into the extracellular fluid. They are metabolized by enzymes such as liver butyrylcholinesterase and plasma pseudocholinesterases. This produces a short duration of action, typically 5-10 minutes long, unlike nondepolarizing blockers, which...
324
General Anesthesia: Overview
215
Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
215


