麻醉剂作为拉皮镜手术中阿片类药物的替代品:一项观察性研究
Niyati Pandya1, Neeta Patel2, Charmi Bhimbha1
1Anaesthesiology, All India Institute of Medical Sciences, Rajkot, Rajkot, IND.
Cureus
|July 21, 2025
概括
使用外周麻醉和全身麻醉的无阿片类麻醉有效地管理腹腔镜手术后的疼痛. 这种方法确保了稳定的血液动力学和最小的副作用,为传统的阿片类药物止痛提供了安全的替代方案.
科学领域:
- 麻醉学 麻醉学
- 手术疼痛管理手术疼痛管理
背景情况:
- 腹腔镜手术通常会导致显著的术后疼痛.
- 阿片类药物是标准的止痛药,但有不良影响,如呼吸抑制和依赖.
研究的目的:
- 评估无阿片类药物多式止痛疗法的疗效,使用外周麻醉与全身麻醉.
- 为了尽量减少阿片类药物需求和腹腔镜手术中的相关并发症.
主要方法:
- 50名接受腹腔镜手术的患者 (ASA等级I-III) 的观察性研究.
- 患者接受了全身麻醉与外围麻醉相结合.
- 评估了外科手术期间的血液动力学和术后的止痛.
主要成果:
- 在整个研究过程中观察到稳定的血液动力学参数 (心率,血压).
- 轻度的手术后疼痛 (VAS 2.76) 在24小时内减少.
- 最小的镇静 (拉姆赛尺度3.72下降到1.96) 和没有显著的认知障碍 (MoCA得分稳定).
- 手术后恶心和吐的发生率为18%,有效管理.
结论:
- 无阿片类药物麻醉与外周罗皮瓦卡因和全身麻醉提供有效的止痛.
- 这种方法确保稳定的血液动力学,可接受的疼痛控制,最小的镇静,没有认知障碍.
- 它为基于阿片类药物的止痛药提供了可行的替代方案,减少了副作用.
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