儿科腺切除术后的阿片类止痛:一项随机临床试验
Rachel L Whelan1,2, Jennifer L McCoy1, Leonid Mirson2
1UPMC Children's Hospital of Pittsburgh, Division of Pediatric Otolaryngology, Pittsburgh, Pennsylvania, USA.
概括
许多接受腺切除术 (AT) 的儿童不需要阿片类药物来缓解疼痛. 非阿片类药物疼痛管理与阿片类药物使用同样有效,儿童患者的结果类似.
科学领域:
- 儿科手术 儿科手术
- 疼痛管理 疼痛管理
- 麻醉学 麻醉学
背景情况:
- 腺切除术 (AT) 是一个常见的儿科手术程序.
- 术后疼痛管理对于恢复至关重要.
- 关于阿片类药物与非阿片类药物在儿科AT疼痛中的作用进行了辩论.
研究的目的:
- 为了比较小儿腺切除术 (AT) 后非阿片类与阿片类疼痛管理的安全性和有效性.
主要方法:
- 一个开放的随机对照试验在三级保健儿童医院进行.
- 接受AT的3-17岁儿童患者被随机分配给接受非阿片类药物 (乙氨基和布洛芬) 或阿片类药物 (乙氨基,布洛芬和 oxycodone).
- 疼痛评分,急诊室的访问,医院再入院和桃体切除术后出血 (PTH) 进行了比较.
主要成果:
- 在非阿片类药物和阿片类药物组之间没有观察到平均疼痛得分的显著差异.
- 阿片类药物消费因年龄而异,年龄较大的儿童 (13-17岁) 消费阿片类药物更频繁.
- 访问急诊室,再入院和PTH的比例在两组之间没有显著差异.
结论:
- 许多儿童,特别是8岁以下的儿童,在AT后不需要阿片类止痛药.
- 非阿片类药物疼痛管理提供了与小儿AT阿片类药物使用相似的结果.
- 对于儿科AT患者,阿片类药物处方应限制或避免.
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