相关实验视频
Updated: May 12, 2025

05:53
Intraoperative Ultrasound in Spinal Surgery
Published on: August 17, 2022
4.5K
在脊椎外科手术中的手术内克隆丁:一个随机对照试验
Stine Birkebæk1, Niels Juul2, Mikkel Mylius Rasmussen1,3
1Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Acta anaesthesiologica Scandinavica
|May 7, 2025
概括
在手术期间静脉注射克洛尼丁并没有降低脊椎手术患者的术后阿片类药物使用或疼痛强度. 克洛尼丁组中低血压更常见,这表明对疼痛管理没有显著的益处.
科学领域:
- 麻醉学 麻醉学
- 疼痛管理 疼痛管理
- 神经外科 神经外科
背景情况:
- 手术后的疼痛是脊椎手术患者的一个重要问题.
- 克洛尼丁是一种α-2激动剂,已表现出止痛特性,可能有助于控制手术疼痛.
研究的目的:
- 评估单次手术内静脉注射克洛尼丁剂在减少脊椎手术患者手术后阿片类药物消耗和疼痛强度方面的疗效.
- 评估克洛尼丁对手术后恶心和吐 (PONV),镇静和低血压等副作用的影响.
主要方法:
- 一项随机,双盲,安慰剂对照试验与120名接受脊柱手术的患者进行.
- 患者接受了手术内静脉注射克洛尼丁 (3μg/kg) 或安慰剂.
- 主要结局是手术后3小时内服用阿片类药物;次要结局包括疼痛强度,PONV,镇静和低血压.
主要成果:
- 在克洛尼丁和安慰剂组 (含有5毫克和10毫克吗啡等效剂) 之间,在手术后的前3小时内,在阿片类药物消耗方面没有发现显著差异.
- 在到达麻醉后护理单位 (PACU) 时,休息时的疼痛强度在两组之间是相似的 (在疼痛量表上是4对3).
- 与安慰剂组 (13名患者) 相比,克洛尼丁组 (24名患者) 的低血压发生频率更高.
结论:
- 单次手术内静脉注射克洛尼丁剂量并不能有效地减少手术后的阿片类药物消耗或脊椎手术患者的疼痛强度.
- 克洛尼丁组中低血压的发病率增加表明存在潜在的安全问题,没有明显的临床益处来缓解疼痛.
相关概念视频
Local Anesthetics: Clinical Application as Spinal Anesthesia
555
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
555
Local Anesthetics: Clinical Application as Epidural Anesthesia
399
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
399
Depolarizing Blockers: Pharmocokinetics
296
Depolarizing blockers are administered through intravenous injection. Succinylcholine is the most common choice of depolarizing blockers in emergency clinical practices. Although they have a rapid onset, they readily diffuse away from the motor end plate into the extracellular fluid. They are metabolized by enzymes such as liver butyrylcholinesterase and plasma pseudocholinesterases. This produces a short duration of action, typically 5-10 minutes long, unlike nondepolarizing blockers, which...
296
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
329
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...
329
Skeletal Muscle Relaxants: Therapeutic Uses
441
Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx...
441

