在大脊椎手术中,无阿片类药物和基于阿片类药物的麻醉:一个潜在的,随机的,受控的临床试验
Hanane Barakat1, Rony Al Nawwar2, Jessy Abou Nader2
1Department of Anesthesiology, Lebanese American University Medical Center-Rizk Hospital, Beirut, Lebanon - hanane.barakat@lau.edu.lb.
Minerva anestesiologica
|June 13, 2024
概括
无阿片类药物麻醉 (OFA) 减少脊柱手术患者的术后吗啡使用和恶心. 虽然OFA可能会增加抗高血压需求和麻醉后护理单位的停留时间,但它提供了一个可行的替代品,以阿片类药物为基础的麻醉 (OBA).
科学领域:
- 麻醉学 麻醉学
- 疼痛管理 疼痛管理
- 脊柱外科手术 脊柱外科手术
背景情况:
- 主要的脊柱手术往往导致严重的疼痛和高阿片类药物使用.
- 无阿片类麻醉 (OFA) 是作为一种治疗疼痛和减少阿片类药物消费的方法.
- 本研究将OFA与脊柱融合患者的传统阿片类麻醉 (OBA) 进行比较.
研究的目的:
- 为了比较手术内OFA与OBA的疗效.
- 评估对术后疼痛,阿片类药物消费和副作用的影响.
- 评估OFA对多层次脊柱融合手术的适用性.
主要方法:
- 经过脊柱手术的48名患者被随机分为OFA或OBA组.
- 在OFA组接受了德克斯梅德托米丁和利多卡因,而OBA组接受了芬太尼和雷米芬坦尼尔.
- 所有患者都接受了西沃弗兰,普罗波,罗库,胺,德克萨米他,丹塞和术后青,以及吗啡患者控制的止痛药.
主要成果:
- 在手术后的前24小时内,OFA组消耗的吗啡显著减少.
- 手术后恶心和吐 (PONV) 的发生率在OFA组较低.
- OFA患者需要更多的抗高血压药物,并且在麻醉后的护理单位停留时间更长.
结论:
- 无阿片类麻醉 (OFA) 是基于阿片类麻醉 (OBA) 的潜在替代方案,用于多层次的脊柱融合.
- OFA有效地减少了早期术后阿片类药物消费和PONV.
- 仔细监测血液动力学变化和延长的PACU停留时间是OFA的必要条件.
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