无阿片类药物麻醉改善了中小型手术的术后恢复质量:一项前性随机对照研究
Pei Wang1, Xia Zhou1, Shijie Wang2
1Department of Anesthesiology, Affiliated Hospital of Qingdao University, University of Qingdao, Qingdao, China.
Minerva anestesiologica
|September 16, 2024
概括
无阿片类药物麻醉 (OFA) 使用乙胺,德克斯梅托米丁和西沃弗卢兰在中小型手术中改善了术后恢复质量. 与阿片类麻醉 (OA) 相比,OFA显著降低了恶心,吐和血液动力学不稳定性.
科学领域:
- 麻醉学 麻醉学
- 术后恢复 术后恢复
- 药理学 药理学是指药理学的学科.
背景情况:
- 阿片类麻醉 (OA) 是标准的,但会引起恶心和吐等副作用.
- 手术后增强恢复 (ERAS) 原则促进了诸如无阿片类药物麻醉 (OFA) 等替代方案.
- 在改善中小型业务的复苏方面,OFA特别重要.
研究的目的:
- 评估OFA对术后康复质量的影响.
- 评估OFA在中小型外科手术中的有效性.
- 为了比较OFA (乙胺,德克斯梅德托米丁,塞沃弗兰) 与OA (苏芬坦尼尔,塞沃弗兰).
主要方法:
- 120名患者被随机分配到OFA和OA组.
- 主要结局:手术后的康复质量-40 (QoR-40) 24小时后的得分.
- 二次结局:血液动力学稳定性和不良事件的发生率,包括术后恶心和吐 (PONV).
主要成果:
- 在OFA组,QoR-40得分 (184.0) 显著高于OA组 (182.0) (P<0.001).
- OFA表现出优越的血液动力稳定性和较低的PONV发病率 (1.6%与25%相比,P<0.001).
- 在OFA组中观察到呼吸抑制的减少和对血管活性药物的需求.
结论:
- 无阿片类药物麻醉在中小型手术中提高术后恢复质量.
- OFA的好处与减少PONV和改善血液动力稳定性有关.
- 在特定的外科手术中,OFA为传统的阿片类麻醉提供了一个有希望的替代方案.
相关概念视频
Opioid Analgesics: Synthetic and Semisynthetic Opioids
251
Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
251
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
58
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
58
General Anesthesia: Overview
198
Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
198
Stages of General Anesthesia
389
Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
389
Parenteral Anesthetics: Overview
111
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
111
Opioid Analgesics: Morphine and Other Natural Cogeners
192
Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
192


