通过皮肤注射的布普伦诺芬贴片作为全关节整形术后多模式止痛的辅助:一项回顾性队列研究
Xiaoli Fang1,2, Yueping Zhao3, Yao Yao4
1China Pharmaceutical University Nanjing Drum Tower Hospital, Nanjing, China.
Frontiers in pharmacology
|October 7, 2024
概括
通过皮肤注射的布普伦诺芬 (TDB) 与NSAIDs结合,在关节或膝盖置换手术后提供有效的疼痛管理. 这种多模式的方法改善了疼痛评分和睡眠质量,但不增加不良事件.
科学领域:
- 整形外科手术 整形外科手术
- 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:
- 整体关节整形术 (THA) 和全膝关节整形术 (TKA) 通常会导致严重的术后疼痛.
- 透皮布伦诺芬 (TDB) 已成为骨科环境中急性疼痛控制的有希望的选择.
- 优化疼痛管理策略对于患者在主要关节置换手术后的康复和满意度至关重要.
研究的目的:
- 为了评估通过皮肤注射布诺芬 (TDB) 贴片与非类固醇抗炎药物 (NSAIDs) 结合用于术后疼痛缓解的疗效和安全性.
- 在接受THA/TKA的患者中,比较不同止痛疗法的有效性,包括TDB和NSAIDs.
- 评估这些止痛策略对疼痛评分,睡眠障碍和整体疼痛缓解率的影响.
主要方法:
- 在2022年1月至2023年1月期间接受THA和TKA的患者的回顾性审查.
- 根据他们的术后止痛疗法,患者被分为三组:A组 (flurbiprofen,tramadol,乙氨基),B组 (flurbiprofen,TDB) 和C组 (Parecoxib,TDB).
- 主要结局包括Wong-Baker面部疼痛量表修订 (FPS-R) 评分和睡眠障碍率;次要结局是疼痛缓解率 (0%, <50%, ≥50%, 100%).
主要成果:
- 与A组相比,B组在THA后的第3天显示出明显较低的FPS-R得分 (P <0.017).
- 在THA和TKA患者中,C组在第2和第3天表现出FPS-R得分最低 (P <0.017).
- 睡眠障碍在B组THA和C组TKA与A组相比显著减少 (P < 0.017);C组THA (P < 0.017) 疼痛缓解率≥50%的比率更高. 所有组的不良反应率在所有组中都是可比的.
结论:
- 透皮布伦诺芬 (TDB) 贴片和NSAIDs的组合代表了一种安全有效的多模式止痛策略,用于管理部和膝盖关节整形术后的疼痛.
- 这种方法可以在术后期改善疼痛控制和减少睡眠障碍.
- 进一步的研究可能会探索特定患者群体和外科手术的最佳TDB-NSAID组合.
相关概念视频
Opioid Analgesics: Synthetic and Semisynthetic Opioids
239
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...
239
Analgesia and Pain Management
547
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...
547
Peripheral Artery Disease V: Postoperative Nursing Management
4
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
4
Drug Delivery: Miscellaneous Routes
329
Drug delivery methods like oral inhalation, nasal sprays, transdermal patches, eye drops, intravitreal injection, and rectal administration provide localized effects with reduced toxicity.
Oral inhalation and nasal sprays swiftly transfer drugs across the respiratory epithelium's mucosal layer. Inhaled glucocorticoids and bronchodilators directly target lung conditions such as asthma, while fluticasone nasal spray mitigates allergic rhinitis.
Transdermal patches transport drugs...
Oral inhalation and nasal sprays swiftly transfer drugs across the respiratory epithelium's mucosal layer. Inhaled glucocorticoids and bronchodilators directly target lung conditions such as asthma, while fluticasone nasal spray mitigates allergic rhinitis.
Transdermal patches transport drugs...
329
Opioid Analgesics: Morphine and Other Natural Cogeners
190
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...
190
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


