在白内障手术中静脉静止与非静脉静止:系统性审查和元分析
Angelica Hanna1, James Jacob Armstrong2,3, Efstathia Tsioros2
1Temerty Faculty of Medicine, University of Toronto, Ontario, Canada.
Journal of cataract and refractive surgery
|April 25, 2025
概括
在白内障手术中,静脉静止剂显著降低了疼痛,而在白内障手术中没有静止剂. 然而,口服和静脉静止提供了类似的疼痛控制,而静止类型之间的并发症没有差异.
科学领域:
- 眼科医生 眼科 眼科
- 麻醉学 麻醉学
- 基于证据的医学基于证据的医学.
背景情况:
- 白内障手术是一种常见的手术,具有不同的镇静实践.
- 镇静方法包括静脉注射 (IV),口服或没有镇静.
- 优化镇静可以提高患者的安全性,体验和医疗保健效率.
研究的目的:
- 为了比较静脉静止剂与非静脉静止剂在常规白内障手术中的有效性.
- 评估不同镇静方式对患者疼痛和术后并发症的影响.
主要方法:
- 一项系统性审查和对12项随机对照试验 (1130名患者) 的随机效应元分析.
- 在Medline,Embase,Cochrane图书馆,BIOSIS,科学网和CINAHL进行了搜索,截至2024年7月.
- 包括将IV与口服或没有镇静剂进行比较的试验,报告疼痛得分或术后并发症.
主要成果:
- 静脉静止剂的疼痛评分明显低于没有静止剂的疼痛评分 (SMD = -0.98).
- 在IV和口服镇静之间没有发现患者报告的疼痛显著差异 (SMD = -0.54).
- 静脉和口服镇静剂的手术内并发症率相似 (OR = 0.68).
结论:
- 静脉静止治疗在减少疼痛方面比在白内障手术中没有静止治疗更有效.
- 口服和静脉静止剂提供可比的疼痛缓解.
- 镇静方式不会显著影响外科手术期间并发症的发生率,为实践指南提供信息.
更多相关视频
相关概念视频
01:24Parenteral Anesthetics: Overview
84
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.
84
01:22Stages of General Anesthesia
298
Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
298
01:24General Anesthesia: Overview
151
Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
151
01:16Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
323
Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
One of the advantages of...
323