排外注射德克斯米德托米丁或埃斯基他明与芬太尼相对,以减少劳动止痛的罗皮瓦卡因使用:一个随机的非劣势性研究
Lifeng Ni1, Shengjie Yao1, Yahong Wu2
1Department of Anesthesiology, Affiliated Xiaoshan Hospital, Hangzhou Normal University, Hangzhou, China.
Heliyon
|May 6, 2024
概括
epidural dexmedetomidine有效地减少了在分娩止痛中使用局部麻醉剂的使用,与芬太尼的疗效相匹配. 然而,外围注射式乙胺并没有证明在分娩期间减少麻醉剂消耗的非劣势性.
科学领域:
- 麻醉学 麻醉学
- 产科 产科 产科 产科 产科
- 药理学 药理学是指药理学的学科.
背景情况:
- 外周麻醉中的非阿片类辅助剂可以降低局部麻醉的需求.
- 患者控制的外周止痛疗法 (PCEA) 是产痛管理的标准.
研究的目的:
- 为了测试德克斯梅托米丁或埃斯基他明作为与罗皮瓦卡因一起的外围注射辅助剂,是否可以与芬太尼在减少分娩期间每小时局部麻醉剂消耗的有效性相匹配.
- 评估与芬太尼相比,德克塞梅托米丁和埃斯基他明在劳动中无产妇妇女中对PCEA的非劣势性.
主要方法:
- 120名正在分娩的无产妇被随机分配给接受PCEA与0.075%的罗皮瓦卡因加上芬太尼,德克斯梅托米丁或胺.
- 主要结局是每小时的罗皮瓦卡因消费,其中20%的差异被认为是临床上显著的非劣势测试.
- 辅助剂度为0.4微克/毫升芬太尼,0.4微克/毫升德克斯梅德托米丁和1.0毫克/毫升乙胺.
主要成果:
- 每小时的罗皮瓦卡因消耗量为12.4毫升/小时 (芬太尼尔组) 和11.9毫升/小时 (德克斯梅德托米丁组),证实非劣势 (风险差异0.5,95% CI -1.0至2.0).
- 埃斯基他明组每小时的罗皮瓦卡因消耗量为14.3毫升/小时,与芬太尼相比,未能满足非劣势标准 (风险差异为1.9,95%CI为0.2至3.6).
- 便秘在芬太尼群中最常见,而轻微的头在乙胺组中最高.
结论:
- 腹膜下注德克斯梅德托米丁在分娩期间作为PCEA的辅助剂,与芬太尼不逊色.
- 在这项研究中,外注乙胺并未被证明在分娩止痛方面不低于芬太尼.
- 这些发现表明,德克斯梅德托米丁可以作为一种可行的替代辅助剂,用于产后外周止痛.
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