在视频辅助胸腔镜手术的术后多式止痛策略上达纳尔布芬脂酸盐的影响:双盲随机对照试验
Hung-Te Hsu1,2, Chao-Wei Ma1, Po-Chih Chang3,4
1Department of Anesthesiology, Kaohsiung Medical University Hospital, Kaohsiung, 80756, Taiwan.
BMC anesthesiology
|May 17, 2025
概括
与安慰剂相比,迪纳尔布芬脂酸盐 (DS) 在视频辅助胸腔镜手术 (VATS) 后显著降低了阿片类药物的使用和疼痛. 这种增强的多模式止痛 (MMA) 策略改善了功能恢复,并为患者提供了长期的疼痛缓解.
科学领域:
- 麻醉学和疼痛管理
- 术后恢复 术后恢复
- 药理学 药理学是指药理学的学科.
背景情况:
- 多模式止痛疗法 (MMA) 结合了各种方法,以优化疼痛控制和尽量减少阿片类药物的使用.
- 长期起作用的纳尔布芬前药物达纳尔布芬脂酸盐 (DS) 被研究其增强MMA策略的潜力.
- 视频辅助胸腔镜手术 (VATS) 通常需要有效的术后疼痛管理.
研究的目的:
- 评估DS的有效性,作为VATS的MMA制度的一部分.
- 为了在DS和安慰剂组之间比较术后阿片类药物消费和疼痛水平.
- 评估DS对增值税后功能性恢复的影响.
主要方法:
- 一个随机对照试验,涉及57名参与者接受VATS.
- 参与者接受了MMA治疗方案与DS或安慰剂,以及超声波引导的胸部副脊椎阻塞 (TPVB).
- 手术后的疼痛是通过静脉注射患者控制的止痛药 (IVPCA) 使用芬太尼治疗突破性疼痛来管理的.
主要成果:
- 与安慰剂组 (708 ± 190 μg,P < 0.001) 相比,DS组在三天内 (283 ± 70 μg) 的芬太尼平均消耗量显著降低.
- 经手术一周和一个月后,DS组的日常生活中的疼痛干扰大大减少 (分别P < 0.001和P = 0.003).
- 运动期间的疼痛强度在DS组在一周和一个月后显著降低 (P<0.001).
结论:
- 通过提供卓越的止痛药,DS显著增强了MMA对VATS的作用.
- 使用DS导致了阿片类药物需求的减少和功能恢复的改善.
- DS显示了长期的效果,改善了患者在出院后的结果.
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