在内镜下粘膜切割手术后给予止痛药:一项回顾性现实研究
Wu Shanshan1,2, Wang Shuren1, Zhang Zongwang1,2
1Department of Anesthesiology, Liaocheng People's Hospital, Shandong University, Liaocheng, China.
Annals of medicine
|May 10, 2025
概括
在内镜下粘膜解剖 (ESD) 后的术后疼痛管理至关重要. 在手术期间使用的凯托洛拉克减少了早期止痛药的需求,而手术地点和方法并没有显著影响止痛药的使用.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 疼痛管理 疼痛管理
背景情况:
- 内镜下粘膜切割 (ESD) 和其衍生技术越来越多地用于胃肠道瘤切除.
- 有效的术后疼痛管理对于患者在这些手术后的康复和满意度至关重要.
研究的目的:
- 为了确定在ESD或其变体后48小时内给予止痛药的频率和时间.
- 确定影响ESD患者术后止痛药使用的因素.
主要方法:
- 这项回顾性观察性研究分析了2162名接受ESD或相关手术的患者的数据.
- 主要结局包括第一次止痛药的使用时间和手术后48小时内止痛药的频率.
- 多变量考克斯回归被用来分析影响因素.
主要成果:
- 26.36%的患者需要术后止痛药,大多数患者在ESD后8小时内 (高峰2小时内) 服用第一剂.
- 在手术期间给予凯托洛拉克显著降低了早期术后止痛药的使用可能性 (HR=0.35,p=0.012).
- 不同的手术场所或方法之间没有发现止痛时间或频率的显著差异,除了ESE的止痛使用率低于EFR (p=0.038).
结论:
- 很大一部分患者需要在ESD后48小时内服用止痛药.
- 临床医生应主动评估和管理术后疼痛,以优化ESD手术后患者的治疗结果.
相关概念视频
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
39
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
39
Peptic Ulcer Disease IV: Management
57
Medical treatment strategies for peptic ulcers encompass various methods. The primary goal of treatment is to diminish gastric acidity and strengthen mucosal defense mechanisms.
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current...
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current...
57
Peptic Ulcer Disease V: Surgical Management and Nursing Care
192
Surgical management and nursing care are crucial in treating Peptic Ulcer Disease (PUD). Here is an organized and enhanced overview of the surgical interventions and the associated nursing care for PUD:
Surgical Interventions for Peptic Ulcer Disease
Surgical Interventions for Peptic Ulcer Disease
192
Endoscopic Procedures I: Esophagogastroduodenoscopy
51
An Esophagogastroduodenoscopy (EGD) is a diagnostic procedure in which an endoscopist uses a flexible, lighted endoscope to visualize the upper gastrointestinal (GI) tract. The procedure includes visualizing the oropharynx, esophagus, stomach, and the first part of the small intestine, the duodenum.
During an EGD, the endoscope can be used to:
During an EGD, the endoscope can be used to:
51
Endoscopic Procedures V: ERCP
53
Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
Patient...
Patient...
53
Drugs for Peptic Ulcer Disease: Prostaglandin Analogs as Mucosal Protective Agents
325
The gastric mucosa produces prostaglandins E2 (PGE2) and prostacyclin (PGI2), crucial in maintaining gastric health. They exert cytoprotective effects, including increasing bicarbonate secretion, releasing protective mucin, reducing gastric acid output, and preventing harmful vasoconstriction. These effects are mediated through various receptors, such as EP1, EP2, EP3, and EP4.
Non-steroidal anti-inflammatory drugs (NSAIDs) can induce peptic ulcers by inhibiting cyclooxygenase, decreasing...
Non-steroidal anti-inflammatory drugs (NSAIDs) can induce peptic ulcers by inhibiting cyclooxygenase, decreasing...
325


