脊柱吗啡和横腹部平面块对剖腹产后阿片类药物需求的比较:一项观察性研究
Suwarman1, Osmond Muftilov Pison1, Mohammad Fikry Maulana1
1Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia.
Local and regional anesthesia
|June 17, 2024
概括
脊髓吗啡是一种长效阿片类药物,与跨腹部平面 (TAP) 块相比,需要较少的额外止痛药来控制剖腹产疼痛. 这一发现支持其在术后疼痛管理中的应用.
科学领域:
- 麻醉学 麻醉学
- 疼痛管理 疼痛管理
- 产科 产科 产科 产科 产科
背景情况:
- 急性术后疼痛影响近90%的剖腹产患者,造成显著的不适和并发症.
- 剖腹产后疼痛管理不足会使慢性疼痛的风险增加2.5倍.
- 剖腹产后增强康复 (ERACS) 协议推吸管内阿片类药物和横腹平面 (TAP) 块用于预防疼痛.
研究的目的:
- 为了在剖腹产患者中比较脊柱吗啡和TAP阻塞之间的阿片类止痛药作为救援药物的需求.
- 为了评估0.1mg脊髓吗啡与TAP阻断与10mg布皮瓦卡因0.2%治疗术后疼痛控制的疗效.
主要方法:
- 在印度尼西亚西爪的一家三级医院进行的观察性研究.
- 患者接受患者控制麻醉 (PCA) 与芬太尼尔用于救援止痛.
- 统计分析包括数值数据的未配对的t测试和分类数据的千平方测试.
主要成果:
- 接受脊髓吗啡治疗的患者需要额外的阿片类药物持续时间较长 (p < 0.05).
- 与TAP阻断组相比,脊髓吗啡组的额外阿片类药物总剂量明显较低 (p < 0.05).
结论:
- 脊柱吗啡的使用导致与横向腹部平面块相比,对额外的阿片类止痛药的总体需求较低.
- 在剖腹产后的急性术后疼痛的管理中,内吗啡可能是减少阿片类药物消费的更有效的策略.
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