经手术时使用德克萨米他分两剂进一步减少了早期的术后恶心和吐,而不是单剂量德克萨米他:一个随机盲目的安慰剂对照试验
Yancheng Chen1, Dawei Niu1, Yinyin Wang2
1Department of Orthopedics, Naval Medical University Second Affiliated Hospital, Shanghai, China.
The Journal of arthroplasty
|July 25, 2024
概括
德克萨米他两剂有效降低了全膝关节整形术 (TKA) 后的术后恶心和吐 (PONV). 这种治疗没有增加血糖,手术部位感染或胃肠道出血风险.
科学领域:
- 麻醉学 麻醉学
- 药理学 药理学是指药理学的学科.
- 整形外科手术 整形外科手术
背景情况:
- 手术后恶心和吐 (PONV) 是全膝关节整形术 (TKA) 后的一个常见并发症.
- 德克萨米他是一种用于管理PONV的皮质类固醇.
- 优化德克萨米他剂量对于TKA中PONV预防至关重要.
研究的目的:
- 为了比较两剂德克萨米他与单剂在TKA后早期PONV降低的疗效.
- 评估术前甲松对疼痛管理和患者报告结果的影响.
- 评估德克萨米他关于血糖水平和手术部位感染 (SSI) 和胃肠道出血 (GIB) 等不良事件的安全性.
主要方法:
- 150名接受TKA治疗的患者被随机分为三个组:安慰剂 (盐水),单剂量德克萨和两剂量德克萨.
- 主要结局包括PONV发病率,严重程度和手术后24小时内使用救援药物.
- 二次结局包括视觉模拟尺度 (VAS) 对恶心/吐,血糖水平和45天内SSI/GIB发病率的评分.
主要成果:
- 与安慰剂相比,单剂和两剂甲疗法显著降低了PONV发病率,严重程度和救援止痛药的需要.
- 在PONV控制中,双剂量德克萨米他疗法比单剂量疗法具有显著的优势.
- 没有观察到手术后血糖水平的显著差异,在任何组中都没有发生SSI或GIB.
结论:
- 经外科手术时使用的德克萨米他,特别是两剂,在预防和治疗TKA后的PONV方面非常有效.
- 德甲不会对术后血糖水平产生不利影响,也不会增加SSI或GIB的风险.
- 优化德克萨米他的使用可以改善患者的康复,并减少TKA后的阿片类药物消费.
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