无阿片类药物与基于阿片类药物的麻醉在腹腔镜袖胃切除术:一个单中心,随机,受控试验
Hanane Barakat1, Linda Gholmieh2, Jessy Abou Nader3
1Department of Anesthesiology, Lebanese American University Medical Center Rizk Hospital, Beirut, Lebanon. hanane.barakat@lau.edu.lb.
Perioperative medicine (London, England)
|February 5, 2025
概括
无阿片类药物麻醉 (OFA) 在接受腹腔镜袖子胃切除术的肥胖患者中没有减少阿片类药物的消耗. 需要进一步的多中心研究来确认OFA在这个患者群体中的有效性.
科学领域:
- 麻醉学和疼痛管理
- 腹部外科手术的结果
- 肥胖医学 肥胖医学
背景情况:
- 阿片类药物是通用麻醉中疼痛管理的标准,但会引起显著的副作用,特别是在接受腹腔镜袖胃切除术的肥胖患者中.
- 探索无阿片类麻醉 (OFA) 对于减轻这些风险至关重要.
- 这项研究比较了OFA与传统的阿片类麻醉 (OBA) 在这个特定的患者群体.
研究的目的:
- 为了评估无阿片类麻醉 (OFA) 与基于阿片类麻醉 (OBA) 的疗效,在接受腹腔镜袖胃切除术的患者中.
- 在麻醉后护理单位 (PACU) 和手术后48小时内评估阿片类药物消耗.
- 为了比较二次结果,包括血液动力学稳定性,输出时间,PACU停留时间和抗emetic需求.
主要方法:
- 一个单中心随机对照试验,涉及83名接受腹腔镜袖胃切除术的患者.
- 患者被随机分配,接受德克斯梅托米丁和利多卡因输液 (OFA) 或雷米芬坦尼尔 (OBA).
- 所有患者都接受了propofol,sevoflurane,神经肌肉阻断剂和胺;结果使用t测试或曼-惠特尼U测试进行了分析.
主要成果:
- 在PACU吗啡消费量,术后总吗啡消费量或OFA和OBA组之间的抗emetic需求之间没有发现统计学上显著的差异.
- 手术后的疼痛水平和其他测量变量在各组之间没有显著差异.
- 在OFA组中,人们注意到对手术内抗高血压剂的需求更高.
结论:
- 无阿片类药物麻醉在接受腹腔镜袖胃切除术的肥胖患者中没有显示出阿片类药物节约作用.
- 更大的多中心研究是必要的,以充分确定OFA在这个人群中的有效性.
- 目前的研究结果表明,OFA在这种特定的外科手术环境中,在降低阿片类药物方面可能不优于OBA.
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