脂质体布皮瓦卡因可以减少手术后的疼痛吗?第三个骨提取后? 一个双盲随机对照试验
Simon Youn1, Katherine Scheker2, Samuel Sheridan3
1Resident, Division of Oral and Maxillofacial Surgery, University of Southern California, Los Angeles, CA.
概括
与标准布皮瓦卡因 (SB) 相比,脂质组布皮瓦卡因 (LB) 在第三提取后提供了适度的疼痛缓解. 这种持久的麻醉剂对于外科手术提取特别有益,改善了术后疼痛管理.
科学领域:
- 口腔和牙面部外科手术
- 麻醉学 麻醉学
- 药理学 药理学是指药理学的学科.
背景情况:
- 脂质体布皮瓦卡因 (LB) 提供了长时间的止痛,但其在第三口抽取疼痛管理中的有效性需要进一步澄清.
- 现有文献缺乏关于LB与标准布皮瓦卡因 (SB) 在第三手术后术后疼痛控制方面的比较有效性的确切证据.
研究的目的:
- 为了比较脂质体布皮瓦卡因 (LB) 与标准布皮瓦卡因 (SB) 在下第三骨提取后治疗术后疼痛的有效性.
- 在分口随机对照试验中评估LB和SB之间的疼痛减轻和止痛持续时间.
主要方法:
- 一个双盲,随机对照试验与分口设计进行了72个受试者接受双边下第三骨提取.
- 受试者在逆侧接受LB或SB,经手术后的疼痛使用10点数值评分尺度 (NRS) 和曲线下面积 (AUC) 分析进行评估.
- 统计比较包括混合效应模型和配对t测试,显著性设置为alpha=0.05.
主要成果:
- 与标准布皮瓦卡因 (SB) 相比,在手术日到术后的第二天,脂质组布皮瓦卡因 (LB) 的疼痛评分明显较低 (P < 0.003).
- 对于双边外科切除术,通过手术后的第3天 (P = 0.02) 显著减少了LB的疼痛.
- 曲线下的面积 (AUC) 分析显示,在整体队列 (P = 0.005) 和特别是双边外科切除 (P = 0.006) 的所有4个术后天,累积疼痛减少与LB.
结论:
- 与标准布皮瓦卡因 (SB) 相比,脂质组布皮瓦卡因 (LB) 提供了与标准布皮瓦卡因 (SB) 相比,在第三提取后,在术后疼痛中提供了适度但统计学上显著的减少.
- 在复杂的外科手术中,LB的止痛效果在第三骨提取中更为明显,这表明它在与更大的疼痛相关的手术中更有用.
- 在接受更具侵入性的牙科外科手术程序的患者中,LB可能是增强疼痛管理的有价值选择.
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