使用低剂量苏芬坦尼尔与低度罗皮瓦卡因相结合的外周体积扩张对剖腹产期间内脏疼痛的影响:一项随机试验
Jin Wang1, Feng Xia1, Li-Ying Wang1
1Department of Anesthesia, Jiaxing University Affiliated Women and Children Hospital, Jiaxing, China.
Pain physician
|December 17, 2024
概括
随着sufentanil和ropivacaine的结合,外周体积延伸 (EVE) 有效地减少了剖腹产期间内脏疼痛. 这种方法还减少了阿片类药物的使用,并改善了患者在手术后的满意度.
科学领域:
- 麻醉学 麻醉学
- 产科麻醉 产科麻醉 产科麻醉
- 疼痛管理 疼痛管理
背景情况:
- 内脏疼痛是剖腹产期间常见的并发症,在联合脊髓-外皮麻醉 (CSE) 下进行剖腹产.
- 周周体积延伸 (EVE) 是一种技术,用于通过周周液球增强脑内阻塞效应.
- 对于EVE与不同药物的有效性,以减少剖腹产后的CSE内脏疼痛,仍未得到充分研究.
研究的目的:
- 为了比较使用低剂量sufentanil单独使用EVE的有效性与低剂量sufentanil和低度ropivacaine的组合,在CSE下的剖腹产期间减轻内脏疼痛.
- 评估这些EVE技术对疼痛严重程度,阿片类药物消耗和患者满意度的影响.
主要方法:
- 一项前性随机受控研究,涉及100名接受CSE剖腹产的患者.
- 患者被分配到四组,在脊髓麻醉后15分钟接受EVE与盐水,罗皮瓦卡因,苏芬坦尼尔或罗皮瓦卡因和苏芬坦尼尔的组合.
- 主要结局是内脏疼痛的发生率,次要结局包括疼痛视觉模拟量表 (VAS) 评分,手术期间的满意度和术后的sufentanil消费.
主要成果:
- 组合组 (罗皮瓦卡因和苏芬坦尼尔) 与盐水 (60%) 和罗皮瓦卡因 (56%) 组相比,内脏疼痛 (12%) 的发生率显著降低.
- 苏芬坦尼尔和组合组均报告了显著较低的VAS得分和更高的手术内满意度.
- 与仅服用苏芬坦尼尔的组相比,组合组显示出较低内脏疼痛发病率的趋势.
结论:
- 使用低剂量sufentanil和低度ropivacaine的组合进行外围注射体积延长,有效地减少了CSE下的剖腹产期间内脏疼痛的发生率和严重程度.
- 这种结合的EVE方法可以降低术后阿片类药物需求,并提高术后患者的满意度.
- 由于研究的局限性,建议进行进一步的研究,包括样本大小和EVE给药时间.
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