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慢性胰腺炎患者复杂胰腺切除术的术后疼痛管理
Supradeep S Madduri1, Kristen R Szempruch2, Dhruv J Patel3
1University of North Carolina School of Medicine, Chapel Hill, NC.
Pancreas
|May 14, 2025
概括
胺可以在经历手术的慢性胰腺炎患者中提供类似于外周止痛药的止痛药. 这项研究表明,胺是治疗术后疼痛的安全有效选择.
科学领域:
- 麻醉学 麻醉学
- 胃肠病学 胃肠病学
- 手术疼痛管理手术疼痛管理
背景情况:
- 慢性胰腺炎的手术后疼痛控制具有挑战性.
- 在一些程序中,如全胰腺切除术与小岛细胞自移植 (TPIAT) 等,外周止痛是禁忌的.
- 凯胺作为替代止痛药的有效性和安全性需要评估.
研究的目的:
- 评估胺在经历胰腺切除术的慢性胰腺炎患者疼痛管理中的有效性.
- 在这个患者群体中,比较胺胺止痛与外周止痛.
- 为了评估胺的安全性和并发症概况与外周止痛相比.
主要方法:
- 一项单中心队列研究包括65名患有慢性胰腺炎的患者 (年龄≥16岁),接受胰腺切除术.
- 患者被分为胺注射和外周止痛组.
- 主要结局:从手术前到出院时,吗啡毫克相当量 (MME) 的变化;次要结局:疼痛评分 (手术后1-5天) 和并发症.
主要成果:
- 开他胺和外周治疗组在出院时的阿片类药物消费 (MME) 没有显著差异.
- 在两组之间观察到类似的疼痛分数.
- 副作用是最小的;幻觉是最常见的胺相关反应 (n=4).
结论:
- 胺在慢性胰腺炎患者中提供类似于外周止痛的阿片类药物节约性止痛.
- 胺是一种可行的,有前途的辅助止痛药,用于治疗胰腺切除术后的疼痛.
- 进一步的研究可能会支持在复杂的胰腺手术疼痛管理中更广泛地使用胺.
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