骨科和腹部手术后的舌下sufentanil:长期结果和安全性
Michael Borck1,2, Jan D Wandrey3,4,5, Claudia Spies3,4
1Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, Berlin, 10117, Germany. michael.borck@charite.de.
Perioperative medicine (London, England)
|February 28, 2025
概括
舌下苏芬坦尼尔片系统 (SSTS) 有效地控制了急性术后疼痛,并预防了妄想. 然而,22%的患者仍然经历了慢性疼痛,并注意到SSTS处理的技术问题.
科学领域:
- 疼痛管理 疼痛管理
- 药理学 药理学是指药理学的学科.
- 临床试验 临床试验
背景情况:
- 急性术后疼痛管理通常涉及阿片类药物通过患者控制的止痛疗法 (PCA).
- 非侵入性舌下sufentanil片系统 (SSTS) 为急性疼痛提供了替代方案,但存在与阿片类药物相关的副作用和长期使用风险.
- 这项研究调查了手术后慢性疼痛 (PCP) 和手术后妄 (POD) 发生率的SSTS.
研究的目的:
- 评估SSTS在治疗急性术后疼痛方面的有效性.
- 为了确定SSTS使用后手术后慢性疼痛 (PCP) 的发生率.
- 在使用SSTS的患者中评估术后妄 (POD) 的发生情况.
主要方法:
- 一项从2017年11月到2021年11月在大学医院进行的纵向队列研究.
- 包括接受PCA计划的选择性膝盖或腹部手术的成年人,在标准疼痛协议之外接受SSTS.
- 不包括孕妇,急诊手术,并发试验参与者和以前的慢性阿片类药物使用者. 3个月和12个月后对疼痛,认知和副作用进行随访.
主要成果:
- 包括80名患者;每日疼痛从手术前的89.2%降至3个月后的45.7%和12个月后的22.5%.
- 在任何病人身上都没有观察到术后妄 (POD).
- 总体上对SSTS的满意度很高 (中位数为8.0/10),但51%的人遇到了与身份验证标签的处理困难.
结论:
- SSTS有效治疗急性术后疼痛而不会引起POD,表现出良好的耐受性.
- 随着时间的推移,术后疼痛显著改善,但22%的人报告了与手术有关的慢性疼痛.
- 识别标签的技术挑战影响了SSTS的整体可行性.
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