揭开高级止痛药的面:胸腔外围注射与直内吗啡在开放的活供体肝切除术 - 一个随机对照试验
Rohit Saini1, Gaurav Sindwani1, Neha Garg2
1Department of Anaesthesiology, ILBS, Delhi, India.
Journal of anaesthesiology, clinical pharmacology
|July 10, 2025
概括
在开放的供体肝切除术中,静脉内吗啡 (ITM) 提供了优异的术后疼痛缓解,相比于开放供体肝切除术中的外周止痛. ITM显著降低了芬太尼的消耗和疼痛评分,增强了这种重大手术后的恢复.
科学领域:
- 麻醉学 麻醉学
- 手术疼痛管理手术疼痛管理
- 肝胆道手术 肝胆道手术
背景情况:
- 有效的术后疼痛管理对于接受开放活供体肝切除术的患者至关重要.
- 传统的外周止痛和较新的脑内甲状腺吗啡技术是治疗这种手术后疼痛的选择.
研究的目的:
- 为了比较内吗啡 (ITM) 与外周止痛疗法在开放式活供体肝切除术中治疗术后疼痛的疗效.
- 为了评估这两种止痛方法之间的阿片类药物消费和疼痛评分的差异.
主要方法:
- 一项涉及60名接受开放活供体肝切除术的患者的比较研究,分为外外注 (EPI) 和内吗啡 (ITM) 组.
- 两组都接受了全身麻醉和术后患者控制的静脉注射芬太尼. 在多个时间点使用数值评分表 (NRS) 评估疼痛.
- 统计分析包括学生的t测试,曼-惠特尼U测试和费舍尔的精确测试来比较结果.
主要成果:
- 与EPI组 (162.5mcg) (P=0.023) 相比,ITM组的患者在头24小时内消耗的术后芬太尼显著减少 (75mcg).
- ITM组报告了在休息状态下,运动期间和手术后长达12小时的肩部疼痛中,NRS得分明显较低 (P=0.000).
结论:
- 在开放的活供体肝切除术中,静脉内吗啡是一种比外周止痛更有效的止痛技术.
- ITM显著降低了阿片类药物需求,并改善了该患者群体的早期术后疼痛控制.
关键词:
腹部疼痛 腹部疼痛在接受开放式活体供体肝切除术的患者中,缺乏将静脉内吗啡与外围注射剂进行比较的研究. 大多数以前的研究都包括了癌症或其他腹部手术患者.止痛药 止痛药 止痛药是一种止痛药.这是一个很好的选择. bupivacaineineine.皮质外注 皮质外注 皮质外注肝切除术 (hepatatectomy) 是一种切除肝脏的方法.利沃布皮瓦卡因 (Levobupivacaine) 是一种药物.肝移植 肝移植 肝移植活着的捐赠者吗啡衍生物吗啡衍生物疼痛 疼痛 疼痛 疼痛在术后的术后生活.肩部疼痛 肩部疼痛 肩部疼痛更多相关视频
12:49Porcine Liver Transplantation Without Veno-Venous Bypass As an Extended Criteria Donor Model
Published on: August 17, 2022
2.5K
05:39Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia
Published on: May 26, 2023
1.8K
相关概念视频
Local Anesthetics: Clinical Application as Epidural Anesthesia
502
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...
502
Opioid Analgesics: Synthetic and Semisynthetic Opioids
438
Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
438
Local Anesthetics: Clinical Application as Spinal Anesthesia
807
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...
807
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
594
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...
594
