静脉注射利多卡因用于大肠外科手术中的肠功能恢复:随机临床试验
Hugh Paterson1,2, Thenmalar Vadiveloo3, Karen Innes4
1University of Edinburgh, Edinburgh, United Kingdom.
JAMA
|November 27, 2024
概括
在经过微侵袭性结肠切除的患者中,术后静脉输注利多卡因在72小时后没有改善肠道功能. 这项研究发现,在利多卡因和安慰剂组之间没有显著的恢复结果差异.
科学领域:
- 大肠直肠手术
- 麻醉学
- 胃肠病学
背景情况:
- 肠道功能延迟是切除术后常见的并发症,影响患者的康复和出院.
- 最少的侵入性手术技术提供了恢复的优势,
研究的目的:
- 评估术前静脉注射利多卡因在选择性微创性结肠切除后加速肠道功能的有效性.
主要方法:
- 这项ALLEGRO试验是一项随机,双盲,安慰剂对照的研究,涉及英国27家医院的590名患者.
- 患者接受了2%的静脉注射利多卡因或盐溶液安慰剂,以玻尿酸剂和连续输注为6小时或12小时.
- 主要结局是手术后72小时恢复肠道功能 (耐受饮食和排便) 的患者比例.
主要成果:
- 总共有557名患者被纳入最终分析 (利多卡因组279名,安慰剂组278名).
- 在利多卡因组的57. 3%患者和安慰剂组的59. 0%患者观察到72小时内肠道功能恢复 (调整后的绝对差异: - 1. 9%;95% CI, - 8. 0%至4. 2%).
- 在主要结果或11个次要结果中没有发现群体之间的统计学意义上的差异.
结论:
- 在选择性微创肠切除后的72小时内,静脉注射利多卡因并没有改善肠道功能.
- 这些发现表明,静脉注射利多卡因对加快胃肠道恢复的效果不佳.
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