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利多卡因与手术后吐的风险在接受桃体切除的儿童:一个随机临床试验
Yang Hu1, Ming-Cheng Du1, Yi Chen1
1Institute of Anesthesiology and Critical Care Medicine, China Three Gorges University and Yichang Central People's Hospital, Yichang, 443000, Hubei Province, China.
Scientific reports
|August 26, 2024
概括
静脉注射利多卡因有效地减少了经过桃体切除术的儿童手术后吐 (POV). 较高剂量的利多卡因显示,POV风险和止痛药救援需求的降低更大,没有报告严重不良事件.
科学领域:
- 麻醉学 麻醉学
- 儿科手术 儿科手术
- 药理学 药理学是指药理学的学科.
背景情况:
- 手术后吐 (POV) 是小儿桃体切除术的常见并发症.
- 在儿童中预防POV的最佳静脉注射利多卡因剂量尚未确立.
研究的目的:
- 研究静脉注射利多卡因的剂量反应关系,以预防儿童在桃体切除术后24小时内发生的POV.
- 评估不同静脉注射利多卡因剂量在减少术后止痛药物需求方面的有效性.
主要方法:
- 一项随机对照试验,涉及3-12岁的患者进行桃体切除术 (带或不带腺切除术).
- 患者被分配到四组,接受不同的静脉注射利多卡因剂量:0,1,1,5或2毫克/公斤.
- 用sufentanil,propofol和suxamethonium化物诱导麻醉,并使用sevoflurane维持麻醉.
主要成果:
- 随着利多卡因的使用,24小时内POV的发病率因剂量而有所下降 (在0mg/kg组为46%,在2mg/kg组为20%).
- 在最高剂量组 (2毫克/公斤) 和对照组 (0毫克/公斤) 之间观察到POV发病率的显著差异.
- 术后止痛救援率也随着利多卡因剂量增加而显著下降,2 mg/kg组显示最低的需求 (16%).
结论:
- 静脉注射利多卡因在减少经过桃体切除术的儿科患者手术后吐的风险方面表现出剂量依赖的疗效.
- 静脉注射利多卡因的2mg/kg剂量与POV和止痛药救援需求发生率最低有关.
- 静脉注射利多卡因可以被认为是预防这一儿科手术群体中POV的安全和有效选择.
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