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机器人辅助囊切除术中的手术内甲对术后阿片类药物需求的影响:一项随机临床试验
Camilla Gaarsdal Uhrbrand1,2, Damir Salskov Obad1, Bente Thoft Jensen3
1Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark.
Acta anaesthesiologica Scandinavica
|November 7, 2024
概括
单次手术内注射甲并没有降低手术后阿片类药物需求,在进行机器人辅助囊切除术 (RAC) 的膀癌患者中. 然而,甲确实增加了患者的满意度与吗啡相比.
科学领域:
- 麻醉学 麻醉学
- 在瘤学瘤学.
- 手术瘤学手术瘤学
背景情况:
- 机器人辅助囊切除术 (RAC) 后的术后疼痛管理存在重大挑战.
- 甲的长时间作用促使人们对其在控制疼痛方面的功效进行了调查.
- 这项研究旨在评估手术内甲,以减少阿片类药物需求和膀癌患者接受RAC的疼痛.
研究的目的:
- 评估单次手术内一剂甲是否能降低经手术后的阿片类药物消耗,在接受RAC的膀癌患者中.
- 为了比较甲和吗啡组之间的疼痛强度,患者满意度和副作用.
主要方法:
- 从2020年7月到2023年8月进行了一项盲目的随机对照临床试验.
- 患者在术前一小时接受了手术内甲 (0.15毫克/千克) 或吗啡 (0.15毫克/千克).
- 主要结局是24小时的阿片类药物需求;次要结局包括疼痛,PONV,镇静和患者满意度.
主要成果:
- 手术后3小时和24小时的阿片类药物消费在甲和吗啡组之间是相似的.
- 吗啡组在48小时后报告疼痛强度明显降低.
- 在24小时内,甲组的患者满意度更高 (p=0.020).
结论:
- 在RAC患者中,单次手术内注射甲并没有降低手术后阿片类药物需求,与吗啡相比.
- 在手术期间使用的甲可能会提高患者在囊切除术后的满意度.
- 在PACU时间或与阿片类药物相关的副作用方面没有观察到显著差异.
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