术内甲对接受orchiopexy的儿童手术后阿片类药物需求的影响:一项随机临床试验
Camilla G Uhrbrand1,2, Karsten H Gadegaard1, Asta Aliuskeviciene1
1Department of Anesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark.
Paediatric anaesthesia
|September 22, 2024
概括
甲的单次手术内剂量降低了小孩经历了orchiopexy的术后阿片类药物需求. 然而,这种疼痛管理策略也导致了更长的停留在麻醉后护理单元.
科学领域:
- 儿科麻醉学 儿科麻醉学
- 疼痛管理 疼痛管理
- 药理学 药理学是指药理学的学科.
背景情况:
- 接受门诊手术的儿科患者面临手术后不充分控制疼痛的风险.
- 甲的长时间作用表明可能会导致持续的术后止痛.
- 之前的研究表明,美沙在青少年疼痛管理中的有效性,但它在年幼的儿童中用于门诊手术疼痛的使用没有被调查.
研究的目的:
- 评估单次手术内甲剂在儿童患者手术后疼痛管理中的有效性.
- 为了评估手术内甲对阿片类药物需求和五岁以下的儿童进行骨折治疗的疼痛强度的影响.
主要方法:
- 进行了一项双盲,随机,安慰剂对照试验.
- 接受皮术的58名5岁以下儿童被随机分配在麻醉诱导期间接受甲 (0.1毫克/公斤) 或盐水.
- 主要结局包括手术后的阿片类药物需求和疼痛强度;次要结局包括脱度,排放准备和睡眠质量.
主要成果:
- 18名儿童需要术后使用阿片类药物;甲组的17%与安慰剂组的42%相比 (p=0.037).
- 在麻醉后护理单位的组之间没有观察到疼痛强度 (FLACC评分≥5) 的显著差异 (p=0.179).
- 接受美沙的儿童经历了较少的与疼痛相关的夜间觉醒,但在麻醉后的护理单位停留时间较长.
结论:
- 单次手术内甲剂量有效降低了儿科骨折症患者的短期术后阿片类药物需求.
- 虽然对疼痛控制有好处,但在这个儿科队列中,手术内甲延长了麻醉后护理单位的停留时间.
- 进一步的研究可能会探索最佳剂量或患者选择以减轻延长恢复时间.
相关概念视频
Opioid Analgesics: Synthetic and Semisynthetic Opioids
246
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...
246
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
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
Analgesia and Pain Management
551
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
551
Local Anesthetics: Clinical Application as Epidural Anesthesia
421
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
421
Drugs Affecting GI Tract Motility: Opioids as Antidiarrheal Agents
178
Diarrhea, a condition marked by frequent loose or watery bowel movements, can be triggered by multiple factors such as viral or bacterial infections, food intolerances, anxiety, medications, and digestive disorders. Symptoms may include abdominal pain, bloating, nausea, and cramping. Severe or prolonged diarrhea can lead to complications like electrolyte imbalances, malnutrition, and dehydration if left untreated.
Opioids, widely used antidiarrheal agents, mitigate diarrhea by slowing down...
Opioids, widely used antidiarrheal agents, mitigate diarrhea by slowing down...
178


