在接受腹腔镜结直肠手术的老年患者中预防性多模式止痛疗法的疗效:随机对照试验
Zhangnan Sun1, Chaolei Liu2, Lining Huang1
1Department of Anesthesiology, the Second Hospital of Hebei Medical University, NO 215Heping West Road, Shijiazhuang, Hebei, 050000, China.
Scientific reports
|October 25, 2024
概括
预防性多式止痛疗法显著减少了腹腔镜直肠手术的老年患者的疼痛,术后胃肠功能障碍和妄想. 这种方法可以促进恢复,并改善肠道健康标志物.
科学领域:
- 麻醉学 麻醉学
- 胃肠病学 胃肠病学
- 老年医学 老年医学
背景情况:
- 接受腹腔镜结直肠手术的老年患者有很高的术后并发症风险.
- 有效的疼痛管理和早期康复对这一群体至关重要.
- 预防性止痛策略旨在减少手术压力并改善结果.
研究的目的:
- 评估预防性多种模式止痛疗法 (PRA) 与术后止痛疗法 (POA) 的有效性,对接受腹腔镜结直肠手术的老年患者.
- 评估PRA对疼痛评分,术后胃肠功能障碍 (POGD) 和术后痴呆症 (POD) 的影响.
- 分析PRA对炎症标志物和肠道微生物群的影响.
主要方法:
- 一项前性随机受控研究,涉及133名老年患者.
- 患者被分为两组:预防性止痛疗法 (PRA) 和术后止痛疗法 (POA).
- 使用视觉模拟尺度 (VAS) 评估疼痛;测量了POGD,POD,IL-6,IL-10和乙烯基胆化酶 (AchE) 水平.
主要成果:
- 与POA组相比,PRA组在手术后24,48和72小时显示出明显较低的VAS得分 (P < 0.001).
- 在PRA组中,POGD和POD的发病率明显较低 (13.43%和8.98%),而不是POA组 (31.82%和24.24%,P<0.05).
- 与POA组相比,PRA组在手术后呈现较低的IL-6和IL-10水平,以及较高的AchE水平 (P < 0.05).
结论:
- 预防性多种模式止痛疗法有效减少腹腔镜结直肠手术的老年患者的疼痛,POGD和POD.
- PRA可以改善术后的胃肠功能恢复.
- PRA对炎症标志物产生积极影响,并促进有益的肠道细菌和短链脂肪酸.
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