临床病理学特征与内科手术期阿片类药物需求在内镜下粘膜剖析与监控麻醉护理期间的关联:一项回顾性研究
Hyun Il Kim1, Da Hyun Jung2, Sung Jin Lee1
1Department of Anesthesiology and Pain Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Republic of Korea.
Journal of clinical medicine
|June 19, 2024
概括
这项研究确定了在监控麻醉护理下进行内镜下粘膜解剖 (ESD) 期间影响阿片类药物需求的因素. 临床病理学特征,如瘤大小和患者因素,如年龄和性别,影响了手术内阿片类药物需求.
科学领域:
- 胃肠病学 胃肠病学
- 麻醉学 麻醉学
- 在瘤学瘤学.
背景情况:
- 内镜下粘膜切割 (ESD) 是早期胃瘤的关键治疗方法.
- 与其他内镜手术相比,ESD需要更高的阿片类药物剂量,在监控麻醉治疗 (MAC) 期间增加风险.
研究的目的:
- 在MAC下接受ESD的患者中调查临床病理特征和手术内阿片类药物需求之间的相关性.
- 在ESD程序期间识别影响阿片类药物消费的因素.
主要方法:
- 743名接受MAC的ESD患者的回顾性审查.
- 多重回归分析以检查芬太尼总剂量 (依赖变量) 与患者人口统计学,ASA状态,生命体征和瘤病理学 (独立变量) 之间的相关性.
主要成果:
- 年龄较小,男性性别,较高的血压,较长的瘤长度和纤维化存在与增加的芬太尼需求有关.
- 对于差异化和不差异化癌症而言,相比于发育不良症,需要更高的阿片类药物剂量.
- 特定的瘤位置 (前壁中部,后壁中部,曲率中部以上,上部) 与更高的芬太尼剂量相关.
结论:
- 几种临床病理和患者因素在MAC下ESD期间显著影响阿片类药物需求.
- 了解这些因素可以帮助预测必要的阿片类药物剂量和管理程序内阿片类药物需求.
- 这种知识可以帮助优化ESD程序的麻醉协议,从而减少潜在的不良事件.
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