基于氧化的多模式止痛疗法在经过重大腹腔镜胃肠道手术后对内脏疼痛的影响:一项随机,双盲,受控试验
Guo-Wang Yang1,2, Hao Cheng1,2, Xiao-Yang Song3
1Department of Anaesthesiology, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China.
Drug design, development and therapy
|June 3, 2024
概括
在主要的腹腔镜胃肠道手术中,基于氧化的止痛药在统计学上比sufentanil更好. 然而,对于患者来说,内脏疼痛的差异并不具有临床意义.
科学领域:
- 麻醉学和疼痛管理
- 手术瘤学手术瘤学
- 药理学 药理学是指药理学的学科.
背景情况:
- 氧化是一种强大的阿片类药物激动剂,有效治疗体质和内脏疼痛.
- 多模式止痛策略对于治疗术后疼痛至关重要.
- laparoscopic胃肠道手术在疼痛控制方面提出了独特的挑战.
研究的目的:
- 为了比较大腹腔镜胃肠道手术后术后疼痛的 oxycodone 与 sufentanil 基多式止痛疗法.
- 用数值评分表来评估这些止痛疗法对内脏疼痛的疗效.
- 确定疼痛管理中的临床重要差异最小值.
主要方法:
- 这是一项随机,双盲,受控试验,涉及40名成年患者.
- 基于手术类型的分层随机化 (1:1).
- 多种类型的止痛包括横向腹部平面块,德克斯梅德托米丁输液,弗鲁尔比乙烯和患者控制的止痛 (PCA) 用氧化或sufentanil.
- 共同主要结局:静止和咳时内脏疼痛的时间加权平均值 (TWA) (0-24小时术后).
主要成果:
- 与sufentanil组相比,oxycodone组在休息时 (1.40 vs 2.00,P=0.039) 和咳时 (2.00 vs 2.98,P=0.006) 的内脏疼痛的24小时TWA显著降低.
- 亚组分析 (年龄,性别,手术类型) 没有改变治疗效果.
- 二次结果,包括切口疼痛,止痛剂使用和不良事件,在两组之间是可比的.
结论:
- 与基于sufentanil的疗法相比,基于oxycodone的多模式止痛疗法证明了术后内脏疼痛的统计显著减少.
- 尽管具有统计学意义,但观察到的内脏疼痛减轻并未被认为具有临床意义.
- 这些发现表明,虽然氧化可能提供统计上的优势,但其对内脏疼痛的临床影响需要在这个患者群体中仔细考虑.
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