在脊柱融合手术期间内置甲对术后阿片类药物需求的影响:一项随机临床试验
Camilla Gaarsdal Uhrbrand1,2, Nicolai Carlé1, Kestutis Valancius3
1Department of Anesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark.
Spine
|August 27, 2025
概括
在腰部融合手术后,单次手术内服用甲并没有减少阿片类药物需求或疼痛. 这项研究没有发现甲和吗啡组之间的疼痛管理有显著差异.
科学领域:
- 麻醉学
- 骨科手术
- 治疗疼痛
背景情况:
- 脊柱融合手术通常会导致严重的急性术后疼痛.
- 甲的延长作用时间为治疗术后疼痛和减少阿片类药物的使用提供了潜在的策略.
研究的目的:
- 确定单次手术内甲剂量是否可以降低术后阿片类药物需求和腰部融合患者的疼痛强度.
- 为了比较切口前和切口前的甲与术后疼痛控制的吗啡的疗效.
主要方法:
- 一个随机盲目的试验,涉及三组接受腰部融合手术的成年患者.
- 患者在切口前接受甲 (0. 2 mg/ kg),在关闭前接受甲 (0. 2 mg/ kg) 或在关闭前接受吗啡 (0. 2 mg/ kg).
- 主要结局包括6小时和24小时的累积阿片类药物需求 (口服吗啡等效),次要结局评估疼痛,恶心,镇静和患者满意度.
主要成果:
- 在手术后6小时和24小时的阿片类药物需求在所有三组 (METpre,METpost和MORpost) 中都是相似的.
- 疼痛强度在不同组之间是相似的,除了METpre组在48小时和72小时后报告的较低的疼痛.
- 两组之间没有观察到副作用,麻醉后护理时间或患者满意度的显著差异.
结论:
- 无论是在切口或关闭前给出的单次手术内甲,与腰部融合后的吗啡相比,都没有显著降低手术后的阿片类药物需求.
- 虽然METpre组在晚些时候的疼痛程度略有降低,但整体上甲在疼痛管理或阿片类药物节约方面没有显著的优势.
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