在腹腔镜妇科手术中,阿片类药物节约全身麻醉对术后恶心和吐的影响
Sun Woo Nam1, Sang-Hwan Do2,3, Jung-Won Hwang2,3
1Department of Anesthesiology and Pain Medicine, Chung-Ang University College of Medicine, Seoul, Korea.
Korean journal of anesthesiology
|August 25, 2024
概括
片节制麻醉 (OSA) 在经过腹腔镜妇科手术的患者中显著降低了术后恶心和疼痛. 这种方法也减少了救援止痛药的需要,而不会导致血液动力学不稳定.
科学领域:
- 麻醉学 麻醉学
- 外科手术的结果
- 疼痛管理 疼痛管理
背景情况:
- 手术后恶心和吐 (PONV) 和疼痛在腹腔镜妇科手术后很常见.
- 片节约麻醉 (OSA) 是一种在手术期间和之后最大限度地减少片使用的策略.
- 在这种特定患者群体中,OSA在减少PONV的有效性需要进一步研究.
研究的目的:
- 为了确定阿片类药物节约麻醉 (OSA) 是否有效地减少手术后恶心和吐 (PONV) 在经过腹腔镜妇科手术的患者.
- 为了比较PONV的发病率,疼痛评分和OSA和传统阿片类药物使用麻醉 (OUA) 组之间的止痛药需求.
主要方法:
- 接受选择性腹腔镜妇科手术的成年患者被随机分为两组:OSA和OUA.
- 在全身麻醉期间,OUA组接受了雷米芬坦尼尔,而OSA组仅接受了一剂单一剂量的阿尔芬坦尼尔用于输管.
- 两组都接受了多式静脉注射非阿片类止痛药的术后治疗. 经过手术后的PONV被评估到手术后的第一天.
主要成果:
- 在麻醉后护理单位 (PACU) 中,恶心的发生率在OSA组 (31.7%) 与OUA组 (51.7%) (P = 0.026) 相比明显较低.
- 在OSA组,疼痛评分和需要阿片类止痛药的需求显著降低,需要救援止痛药的患者减少 (3.3%与18.3%,P = 0.008).
- 两组之间没有观察到手术内生命体征,血液动力学干预或PACU和住院时间的显著差异.
结论:
- 片节制麻醉 (OSA) 有效地减少了手术后的恶心和疼痛,在进行腹腔镜妇科手术的患者.
- 在PACU中,OSA导致了对救援止痛药的需求减少.
- 这种OSA方法不会损害血液动力学稳定性或延长恢复时间.
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