德克斯梅德托米丁是否会影响片类药物在经过骨科手术后的消费?
Allen F Champion1, Jung-Me Lee2, Daniel Taub1
1Associate Professor, Department of Oral and Maxillofacial Surgery, Thomas Jefferson University, Philadelphia, PA.
概括
德克斯梅德托米丁 (DEX) 在正手术患者的术后阿片类药物消耗没有显著改变. 这项研究没有发现DEX给药与减少吗啡毫克相当量 (MME) 或疼痛评分之间的关联.
科学领域:
- 麻醉学 麻醉学
- 药理学 药理学是指药理学的学科.
- 疼痛管理 疼痛管理
背景情况:
- 关于德克斯梅德托米丁 (DEX) 作为一种阿片类药物缓解剂的有效性存在争议.
- 关于DEX在整形外科手术中对术后阿片类药物消费的影响的数据有限.
研究的目的:
- 为了量化手术内用德克斯梅德托米丁 (DEX) 与手术后24小时的阿片类药物消费之间的关联.
- 评估DEX对疼痛评分和患者控制止痛疗法 (PCA) 在整形手术患者的使用的影响.
主要方法:
- 单盲随机前性队列研究.
- 接受正确骨头手术的患者被随机分配到接受DEX或不接受DEX.
- 主要结局:手术后24小时的阿片类药物消费 (MME). 二级结局:视觉模拟尺度 (VAS) 疼痛评分和PCA参数.
主要成果:
- 在DEX和对照组之间24小时MME消费没有统计学上显著的差异 (P=.9).
- 6小时后疼痛评分没有显著差异 (P=.1).
- 在DEX组中观察到较低的VASPCA得分 (P<.01),但PCA尝试与玻尿酸比率相同.
结论:
- 德克斯梅德托米丁的使用与经过正视手术后的阿片类药物消费量减少无关.
- 虽然DEX可能会影响患者报告的疼痛评分,但其在这种情况下的阿片类药物节约作用仍然未被证明.
- 需要进一步的研究,以澄清DEX在形手术多模式止痛中的作用.
相关概念视频
01:24Parenteral Anesthetics: Overview
610
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
610
01:15Opioid Analgesics: Synthetic and Semisynthetic Opioids
931
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...
931
01:22Stages of General Anesthesia
1.5K
Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
1.5K
01:20Opioid Analgesics: Morphine and Other Natural Cogeners
865
Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
865
01:17Sedatives and Hypnotics Drugs: Miscellaneous Agents
518
Sedatives and hypnotics encompass a wide range of substances, each with its unique mechanism of action, uses, and potential adverse effects.
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
518
01:24General Anesthesia: Overview
592
Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
592