添加德克斯梅德托米丁作为辅助剂的有效性与布皮瓦卡因在超声波导向的中间椎结质阻塞的甲状腺切除手术:随机对照研究
Mamdouh Mahmoud Mostafa1, Reham M Gamal1, Aya M Ahmed Baiomy1
1Department of Anesthesia, SICU and pain Management, National Cancer Institute, Cairo University, Cairo, Egypt.
BMC anesthesiology
|March 26, 2025
概括
通过超声波引导的中间宫阻塞 (CPB) 将德克斯梅托米丁添加到布皮瓦卡因,显著改善了甲状腺切除术的恢复. 这种组合延长了疼痛缓解,并减少了对术后阿片类药物的需求.
科学领域:
- 麻醉学 麻醉学
- 术后恢复 术后恢复
- 疼痛管理 疼痛管理
背景情况:
- 手术后的疼痛是甲状腺切除术恢复的关键因素.
- 超声导向的中间椎阻 (CPB) 用于甲状腺切除术疼痛管理.
- 在CPB中使用德克斯梅德托米丁作为布皮瓦卡因的辅助剂需要进一步调查.
研究的目的:
- 为了评估超声波引导的中间CPB的有效性,使用德克斯梅德托米丁作为甲状腺切除术中布皮瓦卡因的辅助剂.
- 为了比较布皮瓦卡因单独的CPB和布皮瓦卡因-德克斯梅德托米丁CPB之间的止痛和术后阿片类药物消费的持续时间.
主要方法:
- 一项随机,双盲,受控的研究,涉及60名接受甲状腺切除术的患者.
- 患者接受了双边中间CPB,单独使用布皮瓦卡因或布皮瓦卡因加上德克斯梅德托米丁.
- 主要结局:缓解疼痛的持续时间;次要结局:手术内使用芬太尼,24小时服用阿片类药物,VAS疼痛评分和并发症.
主要成果:
- 德克斯梅德托米丁组的疼痛缓解持续时间明显长 (p < 0.001).
- 在德克斯梅托米丁组中观察到明显减少的手术内芬太尼消费 (p = 0.005) 和手术后24小时的吗啡消费 (p < 0.001).
- 术后疼痛得分较低,心率和平均动脉压在德克斯梅德托米丁组中被注意到.
结论:
- 在用于甲状腺切除术的超声波导向中间CPB中,添加德克斯梅托米丁与布皮瓦卡因显著延长了疼痛缓解.
- 作为辅助剂的德克斯梅德托米丁有效地减少了手术后的阿片类药物需求和甲状腺切除术后的疼痛.
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