素与德克斯梅德托米丁结合,以减轻选择性剖腹产期间的内脏疼痛,在结合脊髓外周麻醉下:一项双盲随机对照研究
Ji-Rong Yang1, Ying-Yuan Li2, Tao-Jia Ran1
1Department of Anesthesiology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, People's Republic of China.
Drug design, development and therapy
|June 24, 2024
概括
静脉注射的乙胺和德克斯梅德托米丁在剖腹产期间显著降低了手术内内脏疼痛. 虽然这种组合有效缓解疼痛和血动力稳定,但可能会导致暂时的神经或精神副作用.
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:
- 剖腹产通常涉及内脏疼痛,需要有效的止痛药.
- 结合脊柱-外皮麻醉 (CSEA) 是常见的,但可能需要补充疼痛管理.
- 术后内脏疼痛可能会对患者的康复和手术结果产生负面影响.
研究的目的:
- 评估静脉注射埃斯基坦胺与德克斯梅德托米丁结合在减少手术内内脏疼痛方面的疗效.
- 根据CSEA,在选择性剖腹产期间评估这种组合作为补充止痛.
- 为了比较埃斯基坦胺-德克斯梅德托米丁,单独的德克斯梅德托米丁和盐水对内脏疼痛和血液动力学的影响.
主要方法:
- 一项随机对照试验,涉及269名分娩妇女,她们在CSEA中接受了选择性剖腹产.
- 参与者接受了胺 (0.3毫克/千克) 加上德克斯梅托米丁 (0.5微克/千克),单独使用德克斯梅托米丁 (0.5微克/千克),或正常盐水.
- 主要结局是手术期间内脏疼痛;次要结局包括VAS分数和并发症.
主要成果:
- 与单独使用德克斯梅托米丁 (43.8%) 和盐水 (48.6%) 相比,埃斯基他胺-德克斯梅托米丁组的内脏疼痛发生率显著降低 (12.7%).
- 腹部探索和肌肉 suturing 的视觉模拟尺度得分在胺-dexmedetomidine 组明显较低.
- 虽然组合组的平均动脉压较高,心率较低,但过渡性神经/精神症状发生的频率更高 (76.1%).
结论:
- 静脉注射的埃斯基坦胺与德克斯梅德托米丁结合,可以有效地缓解剖腹产期间内脏引的疼痛.
- 这种组合提供了稳定的血液动力学,但可能导致暂时的神经或精神症状.
- 这些副作用通常是自我限制的,并在手术结束时消失.
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