德克斯梅德托米丁与氨基酶相比,以及在失败的背部手术中进行腰部跨门外围类固醇注射:一项随机双盲临床试验
Mina Maher Raouf1, Sherry Shehata Kyriacos1, Manal Hassanein2
1Department of Anesthesia, Intensive Care, and Pain Medicine, Minia University, Minia, Egypt.
Anesthesia and pain medicine
|January 14, 2025
概括
德克斯梅德托米丁 (DEX) 外周注射为背部手术失败综合征提供了优越的疼痛和残疾缓解,与氨酸酶 (HA) 相比. 德克斯提供了一个更实质性的和长期的减轻后拉米切除术的症状.
科学领域:
- 疼痛管理 疼痛管理
- 神经外科 神经外科
- 药理学 药理学是指药理学的学科.
背景情况:
- 失败的背部手术综合征 (FBSS) 在慢性疼痛管理中提出了重大挑战.
- 仅使用类固醇的外周注射由于痕组织的形成,其疗效有限.
- 外周催化剂 (HA) 降解聚合物,而德克斯梅托米丁 (DEX) 降低了炎症.
研究的目的:
- 在管理FBSS时,比较外式德克斯梅托米丁 (DEX) 与氨基酶 (HA) 的疗效.
- 为了评估疼痛减轻和功能改善的患者,持续的后拉美切除术疼痛.
主要方法:
- 一个随机的,双盲的临床试验在拉米切除术后患有持续背部和/或根部疼痛的患者中进行.
- 第一个组接受了布皮瓦卡因,氨,无菌盐水和HA.
- 第二组接受了布皮瓦卡因,氨,无菌盐水和DEX.
主要成果:
- 两组都在注射后显著降低了视觉模拟尺度 (VAS) 疼痛评分和修改的奥斯韦斯特里残疾指数 (MODI) 评分.
- 与HA组相比,DEX组在6个月后显示出疼痛得分的统计学上显著更大降低 (P = 0.003).
- 与HA组相比,DEX组的残疾分数有所改善,没有报告的并发症.
结论:
- 在FBSS患者中,DEX和HA外周注射显著改善疼痛和残疾.
- 与氨基酶 (HA) 相比,德克斯梅德托米丁 (DEX) 在疼痛和残疾方面提供了更明显和持续的改善.
相关概念视频
Local Anesthetics: Clinical Application as Epidural Anesthesia
408
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...
408
Local Anesthetics: Clinical Application as Spinal Anesthesia
576
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
576
Depolarizing Blockers: Pharmocokinetics
305
Depolarizing blockers are administered through intravenous injection. Succinylcholine is the most common choice of depolarizing blockers in emergency clinical practices. Although they have a rapid onset, they readily diffuse away from the motor end plate into the extracellular fluid. They are metabolized by enzymes such as liver butyrylcholinesterase and plasma pseudocholinesterases. This produces a short duration of action, typically 5-10 minutes long, unlike nondepolarizing blockers, which...
305
Parenteral Anesthetics: Overview
96
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
96
Skeletal Muscle Relaxants: Therapeutic Uses
463
Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx...
463


