在阻塞性睡眠呼吸暂停的 palatal 手术后,经外科手术 Celecoxib,乙氨基和阿片类药物消费之间的关联
Ido Badash1, Stephanie Wong1, Kevin Biju1
1Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA.
概括
经外科手术时使用赛莱科克西布,在阻塞性睡眠呼吸暂停 (OSA) 的 palatal手术后24小时内显著减少了阿片类药物消耗. 乙氨基对减少术后阿片类药物使用没有类似的影响.
科学领域:
- 麻醉学 麻醉学
- 药理学 药理学是指药理学的学科.
- 睡眠医学 睡眠医学
背景情况:
- 阻塞性睡眠呼吸暂停 (OSA) 是一种常见的疾病,通常用 palatal 手术治疗.
- 有效的疼痛管理,包括尽量减少阿片类药物的使用,在OSA手术后的术后期至关重要.
- 经常使用非阿片类止痛药,如赛莱科西布和乙氨基,但它们对阿片类药物消费的影响在这种特定的外科背景下需要检查.
研究的目的:
- 调查OSA患者在宫手术后的前24小时内接受赛莱科克西布和乙氨基的外科治疗与阿片类药物的总消耗之间的关联.
- 为了确定这些非阿片类止痛药是否可以有效地减少手术后对阿片类药物的需求.
主要方法:
- 在一个高等学术中心进行了一项回顾性队列研究.
- 包括在2013年7月至2023年6月期间接受软口腔手术的OSA成年患者,但不包括那些经历了喉手术 (除桃体切除外) 或之前使用过阿片类药物的患者.
- 片消费量被量化为吗啡毫克相当量 (MME),并通过多重线性回归分析了与塞莱科克西布和乙氨基使用的关联.
主要成果:
- 总共分析了210名患者,在最初24小时内,他们平均术后阿片类药物消费量为80.2±63.9MME.
- 在外科手术期间使用赛莱科克西布显著与减少MME消费有关 (每100毫克-2.7MME;P = .018).
- 术后使用乙氨基与MME消费的显著变化无关 (P = .43).
结论:
- 在OSA的 palatal手术后的前24小时内,经外科手术后的celecoxib给药与阿片类药物消费的显著减少有关.
- 在这个患者队列中,乙氨基的使用与术后阿片类药物使用没有显著的关联.
- 这些发现表明,切莱科西布可能是OSA palatal手术中阿片类药物节约性止痛的宝贵补充剂.
相关概念视频
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
50
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...
50
Opioid Analgesics: Synthetic and Semisynthetic Opioids
225
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...
225
Analgesia and Pain Management
513
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...
513
Local Anesthetics: Clinical Application as Epidural Anesthesia
413
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...
413
General Anesthesia: Overview
192
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...
192
Opioid Analgesics: Morphine and Other Natural Cogeners
183
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...
183


