系统性利多卡因输液在腹腔镜切除子宫期间对视神经外套直径的影响:一项随机对照研究
Osama M Rehab1, Mohammed S Elsharkawy2, Doha M Bakr3
1Anesthesiology, Surgical Intensive Care and Pain Management Department, Faculty of Medicine, Tanta University, Tanta, Egypt - osamarehab@med.tanta.edu.eg.
Minerva anestesiologica
|September 16, 2024
概括
在腹腔镜切除子宫期间静脉输注利多卡因有效降低内压力 (ICP) 指标和术后疼痛. 这项研究表明,利多卡因减轻了视神经外直径 (ONSD) 的膨胀,并降低了头痛的发生率.
科学领域:
- 麻醉学 麻醉学
- 神经外科 神经外科
- 手术创新 在外科创新.
背景情况:
- laparoscopic 子宫切除术 (LH) 涉及肺上皮 (PP) 和Trendelenburg位置 (TP),这会增加腹内和胸内压力,从而增加内压力 (ICP).
- 视神经外直径 (ONSD) 是一个验证的替代标记,用于监测手术过程中的ICP波动.
研究的目的:
- 评估静脉注射 (IV) 利多卡因在缓解PP和TP与LH期间ICP上升的疗效.
- 评估IV利多卡因对ONSD的影响,这是ICP的一个关键指标.
主要方法:
- 一个随机的,安慰剂对照试验,涉及66名接受LH治疗的患者.
- 患者被分配给接受IV利多卡因或盐水 (安慰剂).
- 在多个时间点进行了ONSD测量,同时对术后疼痛 (数值评分表 - NRS) 和不良影响进行了评估.
主要成果:
- 与安慰剂组相比,利多卡因组在PP和TP启动后30分钟和60分钟显示出明显较低的ONSD值 (分别P=0.003和P=0.004).
- 接受IV利多卡因治疗的患者在到达麻醉后护理单位 (PACU) 时报告了显著较低的NRS疼痛评分 (P = 0.016).
- 在利多卡因组 (P = 0.029) 中观察到手术后头痛的发病率降低.
结论:
- 在LH期间静脉注射利多卡因有效减轻ONSD膨胀,表明ICP的减少.
- 输液利多卡因还在PACU到来时提供了显著的疼痛缓解,并降低了术后头痛的发生率.
- 利多卡因在进行腹腔镜切除子宫的患者中,代表了管理ICP和疼痛的宝贵补充剂.
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