与传统阿片类麻醉相比,阿片类节约麻醉的安全性和有效性:一个范围审查
Maria P Lauretta1, Luca Marino2, Federico Bilotta3
1Department of Medicine and Surgery Sciences, Anaesthesiology and Pain Medicine Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico S.Orsola-Mapighi of Bologna, Bologna.
The Clinical journal of pain
|January 8, 2025
概括
片节约麻醉 (OSA) 通过使用非片辅助剂和地方区域技术,有效地减少与片相关的并发症. 与传统的阿片类麻醉 (OA) 相比,这种方法证明了安全性和有效性.
科学领域:
- 麻醉学和外科手术期间的医学.
- 药理学和治疗学 药理学和治疗学
- 手术结果研究研究
背景情况:
- 基于阿片类药物的麻醉 (OA) 与严重的并发症有关.
- 片节约麻醉 (OSA) 是为了使用多式联络方法减轻这些风险而开发的.
- 关于OSA与OA的比较安全性和有效性的证据需要合成.
研究的目的:
- 与基于阿片类药物的麻醉 (OA) 相比,提供阿片类药物节制麻醉 (OSA) 的安全性和有效性的临床证据.
- 审查评估OSA协议及其对术后结果的影响的研究.
- 综合有关OSA在减少阿片类药物相关并发症的有效性方面的发现.
主要方法:
- 进行了范围审查 (ScR),重点是比较OSA和OA的研究.
- 在PubMed和EMBASE数据库中,使用与OSA并发症,疗效和安全相关的关键词进行了搜索.
- 来自25项纳入研究的结果根据文章特征,研究目标,OSA协议和外科设置进行了分类.
主要成果:
- 研究报告说,在OSA中使用α2激动剂时,手术内血动力学波动较低.
- 包括α2激动剂,NMDA受体抑制剂, gabapentinoids 和局部区域技术在内的OSA方法对大多数术后终点产生了积极影响.
- 在OSA和OA之间没有发现整体并发症率的显著差异,除了血液动力学稳定性.
结论:
- 片节制麻醉 (OSA) 是一个可行的外科手术期间的策略.
- 临床实施涉及非阿片类药物和局部区域麻醉技术.
- OSA有效地减少了与阿片类药物相关的并发症,而不会影响患者的安全.
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