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在接受桃体切除手术的高风险儿童中使用外科阿片类药物 - - 一个机构的经验
Asher C Park1, Kathleen Billings2, John Maddalozzo2
1Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
American journal of otolaryngology
|August 16, 2024
概括
接受桃体切除术/腺切除术的高风险儿童在接受无阿片类药物或阿片类药物止痛药时都经历了类似的疼痛管理和氧气水平. 在这些复杂的儿科病例中,无阿片类药物治疗疼痛是一种可行的选择.
科学领域:
- 儿科麻醉学 儿科麻醉学
- 疼痛管理 疼痛管理
- 睡眠医学 睡眠医学
背景情况:
- 在高风险儿童中,桃体切除/腺切除 (T/AT) 可以导致严重的术后疼痛.
- 高风险患者包括患有严重阻塞性睡眠呼吸暂停,复杂并发症或2岁以下的患者.
- 评估疼痛管理及其对该人口氧化的影响至关重要.
研究的目的:
- 评估高风险儿科T/AT患者的术后疼痛管理策略.
- 为了确定疼痛管理对氧气水平和疼痛评分在延长后麻醉护理单位 (PACU) 停留期间的影响.
- 为了比较基于阿片类药物和无阿片类药物止痛疗法之间的结果.
主要方法:
- 在一家三级儿童医院进行的回顾性病例系列.
- 包括278名接受T/AT的高风险儿科患者.
- 分析手术内止痛药的使用,PACU疼痛药的需求,以及氧气脱的事件.
主要成果:
- 手术期间的阿片类药物剂量往往低于推的最大剂量 (标准的54-63%).
- 无阿片类药物止痛药 (乙氨基,布洛芬) 用于高剂量 (93-100%标准剂量) 的治疗.
- 与阿片类药物使用相比,无阿片类药物止痛症与救援止痛药的增加需求或PACU中较高的氧气脱度率无关.
结论:
- 高风险儿科T / AT病例的外科疼痛管理是可变的.
- 无阿片类药物止痛疗法在PACU中显示出与手术内阿片类药物使用相比的安全性和疗效,在氧化和疼痛管理方面具有可比性.
- 这些发现支持在这个脆弱的儿科群体中考虑无阿片类药物止痛.
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