在非腹部手术中使用内吗啡:一个范围审查
Aart Jan W Teunissen1,2, Lieke van Gastel2, Robert J Stolker2
1Maasstad Hospital, Anaesthesiology, Rotterdam, the Netherlands.
内吗啡有效减少术后疼痛和阿片类药物在非腹部手术,如脊柱和骨科手术中的使用. 然而,和恶心等潜在的副作用需要仔细考虑.
科学领域:
- 麻醉学 麻醉学
- 疼痛管理 疼痛管理
- 术后恢复 术后恢复
背景情况:
- 在非腹部外科手术中,内吗啡有可能缓解手术后的疼痛,并增强非腹部手术的恢复方案.
- 对副作用的担忧限制了其广泛采用.
- 本综述涉及内吗啡的疗效,剂量和不良事件.
研究的目的:
- 评估内吗啡在非腹部外科手术中治疗术后疼痛的有效性.
- 为了确定合适的剂量,用于静脉注射吗啡的管理.
- 评估与内吗啡使用相关的不良影响.
主要方法:
- 在非腹部外科手术中对内吗啡进行随机对照试验 (RCT) 的系统搜索.
- 范围审查方法用于分析75个涉及4685名患者的RCT.
- 包括偏见评估用于全面分析.
主要成果:
- 在脊柱,胸部和下肢整形外科手术中,静脉内吗啡显著减少了术后疼痛和阿片类药物消耗.
- 常见的不良反应包括,术后恶心和吐,以及尿液保留,特别是在骨科手术中.
- 低至中等剂量 (<500μg) 不与延迟呼吸抑制有关.
结论:
- 在各种非腹部手术中,内吗啡是治疗术后疼痛的有效选择.
- 内吗啡的好处必须与可能影响住院时间的潜在副作用相平衡.
- 进一步的研究可能会完善最佳剂量和副作用管理策略.
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