在视频辅助胸腔镜外科手术中,在手术期间使用无阿片类药物使用胺与阿片类药物节约麻醉:一项随机对照试验
Hoon Choi1, Jaewon Huh1, Minju Kim1
1Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.
Journal of personalized medicine
|August 29, 2024
概括
在视频辅助胸腔镜手术 (VATS) 中使用胺的无阿片类麻醉 (OFA) 显示出可行性并改善了短期疼痛控制. 虽然康复质量得分在统计学上更高,但差异在临床上并不显著.
科学领域:
- 麻醉学 麻醉学
- 胸部外科手术 胸部外科手术
- 疼痛管理 疼痛管理
背景情况:
- 阿片类药物对术后疼痛是有效的,但会引起不良影响.
- 无阿片类药物麻醉 (OFA) 消除了手术内阿片类药物的使用.
- 在视频辅助胸腔镜手术 (VATS) 中OFA的证据有限.
研究的目的:
- 与阿片类药物节约性麻醉 (OSA) 相比,评估使用凯胺的OFA在VATS患者的效果.
- 评估恢复质量 (QoR),术后疼痛和不良事件.
主要方法:
- 91名接受VATS叶切除术或细分切除术的患者被随机分配到OFA (胺) 或OSA (雷米芬坦尼尔).
- 主要结局:手术后一天 (POD) 的 QoR-40 问卷 1.
- 二级结局:术后疼痛评分 (视觉模拟尺度) 和不良事件 (PONV,).
主要成果:
- 在POD1上,OFA组的QoR-40得分较高 (164.3比158.7),但没有临床意义.
- 手术后0-1小时 (4.2比6.2) 和1-4小时 (3.4比4.6) 的OFA组的下视觉模拟尺度疼痛得分.
- 在OFA组中,手术后恶心和吐 (PONV) 和的发生率降低.
结论:
- 使用胺的OFA对VATS是可行的,保持稳定的血液动力学,避免手术期间的意识.
- OFA在短期疼痛方面表现出统计学上显著的改善,并减少了PONV/.
- 虽然QoR显示了统计上的改善,但与OSA相比,它没有达到临床意义.
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