在门诊和门诊环境中使用吸入的甲氧化 (Penthrox):系统性审查
Bibi Zeyah Fatemah Sairally1,2, Prathiba M De Silva3,2, Paul Smith2
1Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK zeyah.sairally@nhs.net.
BMJ open
|February 17, 2025
概括
在门诊手术期间,Penthrox (methoxyflurane) 显示出缓解门诊过程中的疼痛的潜力. 然而,它的有效性各不相同,需要更多的研究来证实它的好处与其他止痛方法相比.
科学领域:
- 麻醉学和疼痛管理
- 药理学 药理学是指药理学的学科.
- 基于证据的医学基于证据的医学.
背景情况:
- 有效的疼痛管理对于患者的舒适性和门诊环境中的程序成功至关重要.
- 甲氧化,作为Penthrox销售,是一种用于止痛的吸入剂.
- 评估其在选择性干预程序中的有效性对于临床实践很重要.
研究的目的:
- 系统地审查有关Penthrox (methoxyflurane) 在选择性门诊干预手术期间和之后缓解疼痛的疗效的文献.
- 将Penthrox与其他止痛方法进行比较,包括安慰剂和静脉静止剂.
- 确定需要进一步研究的领域.
主要方法:
- 对已发表的研究进行系统审查,包括随机对照试验 (RCT) 和对干预的非随机研究 (NRSI).
- 在多个数据库 (Cochrane,MEDLINE,Emcare,Embase,ClinicalTrials.gov,CINAHL) 进行了搜索,截至2023年11月.
- 数据提取和偏差风险评估是由两个独立的审稿人进行的;由于异质性,元分析是不可行的.
主要成果:
- 十二项研究 (5项RCT,7项NRSI) 符合纳入标准,涵盖了胃肠病学,妇科,血液学,骨科和泌尿病学的程序.
- 两个RCT表明,使用Penthrox与安慰剂相比,Penthrox显著减少了手术内疼痛.
- 然而,三个RCT和NRSI显示出可变的结果,与安慰剂或IV镇静剂相比,疼痛或舒适度没有显著差异. 患者满意度一般很高 (63%至>98%),大多数研究报告 (46.8%-95%),患者愿意再次使用它. 没有报告任何严重的不良事件.
结论:
- 潘特洛克斯 (甲氧氨酸) 显示出作为侵袭性,选择性门诊手术的止痛药的潜力.
- 它的相对益处似乎取决于具体的干预和使用的比较疼痛控制方法.
- 显然需要大型,强大的多中心RCT来最终评估Penthrox的有效性.
相关概念视频
Inhalational Anesthetics: Overview
166
Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...
166
Parenteral Anesthetics: Overview
92
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.
92
Respiratory Assessment: Purpose and Indications
1.0K
Respiratory assessment is a cornerstone of nursing assessments, crucial for the early detection of patient deterioration. This evaluation transcends routine procedures, representing a critical skill nurses must master to ensure optimal patient care.
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...
1.0K
Inhaled Medications
219
Inhaled medications are crucial for managing chronic obstructive pulmonary disease (COPD) and asthma. They are essential for effective treatment and control, ensuring optimal respiratory health and well-being. Inhaled medication delivers drugs directly to the lungs, providing a rapid onset of action and reducing systemic side effects compared to oral or injectable medications. Three primary types of inhalation devices are used to administer these medications: nebulizers, metered-dose inhalers...
219
Drugs Used in Lower Respiratory Disorders: Overview
343
Lower respiratory tract disorders present challenges that often require skilled and nuanced approaches for effective management. Common ailments, such as asthma and chronic obstructive pulmonary disease (COPD), have prompted the development of intricate treatment strategies involving bronchodilators and anti-inflammatory drugs, each tailored to ease breathing and revitalize the lungs.
Bronchodilators, the first step of respiration enhancement, come in various forms, each with its own mechanism...
Bronchodilators, the first step of respiration enhancement, come in various forms, each with its own mechanism...
343
Antiasthma Drugs: Methylxanthines
187
Theophylline, a member of the methylxanthine class of bronchodilators, has long been used in asthma management. While its exact mechanism of action is not fully understood, it is believed to have multiple effects on various cellular processes.
Theophylline is thought to inhibit phosphodiesterase enzymes, increasing intracellular levels of cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP). This rise in cAMP and cGMP concentrations stimulates cardiac function,...
Theophylline is thought to inhibit phosphodiesterase enzymes, increasing intracellular levels of cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP). This rise in cAMP and cGMP concentrations stimulates cardiac function,...
187


