术内给药Esketamine与腹腔镜妇科手术后减少阿片类药物消费有关:一项随机对照试验
Chen Huan1, Ting Zhang1, Yiling Jiang1
1Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.
Drug design, development and therapy
|January 20, 2025
概括
在低剂量和高剂量中,手术期间使用的乙胺,在妇科 laparoscopic 手术后有效减少了阿片类药物的使用. 这种阿片类药物节约效应在没有增加患者不良事件的情况下观察到.
科学领域:
- 麻醉学 麻醉学
- 药理学 药理学是指药理学的学科.
- 妇科外科手术 妇科外科
背景情况:
- 手术后疼痛管理通常依赖于阿片类药物,这些药物会带来不良事件的风险.
- 尽量减少阿片类药物消费是提高手术恢复的关键目标.
- 埃斯凯特胺是一种麻醉剂,具有潜在的止痛特性.
研究的目的:
- 为了评估不同剂量的手术内用乙胺的阿片类药物节约效果.
- 评估在妇科 laparoscopic 手术中与手术内使用斯基坦胺相关的不良事件的发生率.
主要方法:
- 一项随机对照试验,涉及120名接受选择性妇科腹腔镜手术的患者.
- 三组:较低剂量的乙胺 (0.25毫克/千克 + 0.20毫克/千克/小时),较高剂量的乙胺 (0.50毫克/千克 + 0.40毫克/千克/小时) 和控制 (盐水).
- 术后疼痛通过患者控制的止痛疗法 (PCA) 治理. 苏芬坦尼尔和特拉马多尔救援止痛.
主要成果:
- 与对照组相比,低剂量和高剂量乙胺组在24小时和48小时的PCA阿片类药物消耗显著减少.
- 在低剂量和高剂量乙胺组之间,没有发现阿片类药物消费的显著差异.
- 在三个组之间没有观察到输出时间,术后疼痛强度或不良事件发生率的差异.
结论:
- 在两个评估剂量的内科手术时,在接受妇科腹腔镜手术的患者中有效降低了术后的阿片类药物消耗.
- 在这种患者群体中,施用埃斯凯他并没有增加不良事件的风险.
- 在这种手术环境中,埃斯凯特胺是一种可行的选择,用于阿片类药物节约性止痛.
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
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
47
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
47
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
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
Local Anesthetics: Pharmacokinetics
727
The potency and duration of action of local anesthetics (LAs) are determined by their pharmacokinetics. Pharmacokinetics describes how LAs are absorbed, distributed, metabolized, and eliminated from the body. When administered to the vascular tissues, LAs are quickly absorbed and enter the systemic circulation, reducing their localized effects. Adding vasoconstrictors such as epinephrine to LAs reduces their absorption into the systemic circulation, making them clinically effective. The...
727
Local Anesthetics: Common Agents and Their Applications
397
Local anesthetics (LAs) are commonly used for various applications in medical and dental procedures. Some of the common agents used are cocaine, lidocaine, and bupivacaine.
Cocaine is an ester of benzoic acid and methylecgogine. It is used to anesthetize and vasoconstrict locally. Currently, it is used primarily for topical applications. It is beneficial for surgeries on the upper respiratory tract, providing anesthesia and shrinking the mucosa. Cocaine in the form of cocaine hydrochloride is...
Cocaine is an ester of benzoic acid and methylecgogine. It is used to anesthetize and vasoconstrict locally. Currently, it is used primarily for topical applications. It is beneficial for surgeries on the upper respiratory tract, providing anesthesia and shrinking the mucosa. Cocaine in the form of cocaine hydrochloride is...
397


