术后利多卡因和胺对低血压手术中吗啡需求的影响
Gregory Contreras Pérez1, Carolina Frederico Avendaño2, Luis Ignacio Cortínez3
1Hospital HM Nou Delfos, Hospitales HM, Barcelona, Spain.
Obesity surgery
|March 17, 2025
概括
经过长时间的术后利多卡因和胺注射并没有显著减少腹部外科手术患者的吗啡消耗. 虽然疼痛评分在四小时后较低,但延长输液的整体结果并不能证明是合理的.
科学领域:
- 麻醉学 麻醉学
- 疼痛管理 疼痛管理
- 腹部外科 腹部外科
背景情况:
- 减肥手术后有效的疼痛管理至关重要,但由于阿片类药物相关的不良影响,具有挑战性.
- 多模式止痛策略是减少术后阿片类药物使用的关键.
- 这项研究研究了长时间的利多卡因和胺注射作为一种补充方法.
研究的目的:
- 为了评估90分钟的术后利多卡因和胺输液对吗啡消费的影响.
- 评估这种多模式方法在代谢性减肥手术后的疼痛管理中的有效性.
主要方法:
- 这是一项追溯的队列研究,对64名接受袖子胃切除术或Roux-en-Y胃旁路术的患者进行.
- 32名接受利多卡因/胺注射的患者 (A组) 与32名接受标准止痛药的患者 (B组) 的比较.
- 主要结局:在前48小时内消耗了全部吗啡;次要结局:视觉模拟尺度 (VAS) 疼痛分数在多个时间点.
主要成果:
- 在48小时内,A组的平均吗啡摄入量为0.82毫克,B组为2.03毫克 (p=0.0696).
- 62.5%的患者在前48小时内不需要吗啡.
- 手术后4小时,A组的VAS分数显着较低 (1.03对2.16,p=0.0024).手术后4小时,A组的VAS分数显著较低 (1.03对2.16).
结论:
- 多式联络方法导致整体吗啡消耗和疼痛得分较低.
- 这些发现不支持术后延长利多卡因和胺注射90分钟.
- 进一步的研究可能会探索最佳疼痛控制的替代持续时间或组合.
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