程序时间对儿童手术后阿片类药物需求的影响
Clinton L Fuller1, Maxwell Lee2, Kathleen E Hosek3
1Department of Pediatric Anesthesiology, Perioperative, and Pain Medicine, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA.
Acta anaesthesiologica Scandinavica
|December 3, 2024
概括
夜间手术没有改变儿童手术后的阿片类药物需求. 在白天,阿片类药物需求仍然较高,无论尾切除术何时进行. 这表明昼夜节律的变化不会在儿科尾切除术中显著影响疼痛管理.
科学领域:
- 儿科手术 儿科手术
- 麻醉学 麻醉学
- 循环节生物学 日间生物
背景情况:
- 儿童手术后的疼痛管理至关重要.
- 成年人在止痛药需求中表现出昼夜模式,在早上需要更高的要求.
- 手术的时间可能会影响昼夜节律和随后的疼痛感知.
研究的目的:
- 调查夜间手术是否会改变儿童手术后的阿片类药物需求.
- 为了确定昼夜节律的变化是否会影响阿片类药物需求峰值的时间.
- 测试夜间手术导致儿科患者夜间阿片类药物需求增加的假设.
主要方法:
- 对999名儿童 (年龄在1-18岁) 进行了复杂尾炎的腹腔镜尾切除术的回顾性队列研究.
- 在2018年1月至2019年12月期间收集的数据.
- 在白天和晚上进行手术的儿童之间,总体,白天和夜间手术后的吗啡等价物 (mg/kg) 的比较.
主要成果:
- 与白天 (n=758) 进行手术的儿童相比,在夜间进行手术的儿童 (n=241) 的阿片类药物总需求略高,尽管这种差异在所有措施中都不是统计学上显著的.
- 无论手术时间如何,所有儿童在白天需要更多的吗啡相当剂,而不是在夜间.
- 由于夜间手术,没有观察到因夜间手术而导致阿片类药物需求峰值时间的显著变化.
结论:
- 在患有复杂尾炎的儿童中,腹腔镜尾切除的白天时间不会显著影响术后阿片类药物需求.
- 在这个儿科患者群体中,循环节律似乎没有将阿片类药物需求转移到夜间手术后的夜间时间.
- 尾切除术后的白天时间始终显示出更高的止痛需求,不管手术的时间是什么.
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