在腹腔镜袖子胃切除随机试验中,阿片类药物节约性麻醉对PONV的影响
Kai-Rui Shi1, Min Zhao1, Ke Liu1
1Department of Anesthesiology, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou, Jiangsu 225300, China.
iScience
|September 2, 2025
概括
在腹腔镜套胃切除术 (LSG) 后,阿片类药物节约性麻醉 (OSA) 显著减少术后的恶心和吐 (PONV). 这种方法提供了可比的疼痛缓解和恢复,同时通过降低PONV发病率改善了患者的结果.
科学领域:
- 麻醉学
- 胃肠病学
- 减肥手术
背景情况:
- 手术后恶心和吐 (PONV) 是 laparoscopic 袖子胃切除术 (LSG) 后的一个常见并发症.
- 术内使用阿片类药物是LSG患者PONV高发病率的一个重要因素.
研究的目的:
- 为了比较基于乙胺的阿片类药物缓解麻醉 (OSA) 与传统的阿片类药物缓解麻醉在LSG后减少PONV的疗效.
- 评估OSA对LSG患者的术后疼痛管理和恢复的影响.
主要方法:
- 进行了一项前性,双盲,随机对照试验.
- 接受LSG的成年患者被分配到OSA或阿片类麻醉组.
- 主要测量结果是术后48小时内PONV的发生率.
主要成果:
- 与阿片类麻醉相比,OSA在术后48小时内显著减少了PONV的总发病率.
- 在前24小时内观察到PONV发病率的临床显著降低.
- 在OSA组的6 - 24小时术后期间,PONV的严重程度显著降低.
- 这两种麻醉方法的止痛效果和术后恢复是可比的.
结论:
- 基于esketamine的阿片类药物缓解麻醉 (OSA) 是在接受LSG的患者中缓解PONV的有效策略.
- 在LSG中,OSA为麻醉管理提供了有价值的替代方案,改善了患者的舒适度,并减少了PONV负担,而不会影响疼痛控制.
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