在肺切除手术后基于利多卡因与基于苏芬坦尼尔的PCIA:随机对照试验
Bin Tian1, Yumin Wu2, Wenjie Zhang3
1Department of Anesthesiology, Gansu Provincial Hospital, Lanzhou, People's Republic of China.
Drug design, development and therapy
|September 25, 2025
概括
基于利多卡因的患者控制的静脉注射止痛疗法 (PCIA) 为胸腔镜肺部手术患者提供了优越的疼痛缓解和增强的恢复,与基于sufentanil的PCIA相比. 这种方法还减少了手术后的恶心和吐,使其成为治疗疼痛的宝贵选择.
科学领域:
- 麻醉学 麻醉学
- 疼痛管理 疼痛管理
- 胸部外科手术 胸部外科手术
背景情况:
- 术后疼痛管理对于胸腔镜肺部手术后的恢复至关重要.
- 患者控制的静脉静脉止痛疗法 (PCIA) 是一种常见的手术疼痛管理方法.
- 对PCIA进行不同止痛药物的比较对于优化患者的治疗结果至关重要.
研究的目的:
- 为了比较基于利多卡因的PCIA与基于sufentanil的PCIA的疗效和安全性.
- 评估对经过胸腔镜肺部手术的患者手术后疼痛和恢复质量的影响.
- 评估各种恢复参数和炎症标志物.
主要方法:
- 一项随机研究涉及160名接受胸腔镜肺部手术的患者.
- 患者接受了基于利多卡因的PCIA (1.5 mg/kg/h) 或基于sufentanil的PCIA (2 μg/mL).
- 主要终点是视觉模拟尺度 (VAS) 疼痛评分;次要终点包括恢复质量-15 (QoR-15) 评分,恢复时间里程碑和炎症标志物.
主要成果:
- 利多卡因PCIA在术后6小时,12小时和24小时显著降低VAS疼痛得分.
- 在利多卡因组中观察到更高的QoR-15分数和改善的身体舒适度和疼痛尺寸.
- 利多卡因组的第一次浮,排便和行走时间较短,炎症标志物 (IL-6,TNF-α,IL-8) 的水平较低,术后恶心和吐减少.
结论:
- 基于利多卡因的PCIA在胸腔镜肺部手术后治疗术后疼痛方面比基于sufentanil的PCIA更有效.
- 利多卡因PCIA显著提高了康复的质量,并减少了恶心和吐等不良事件.
- 基于利多卡因的PCIA在这种患者群体中为术后止痛提供了相当大的和有利的选择.
相关概念视频
Local Anesthetics: Clinical Application as Epidural Anesthesia
687
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...
687
Local Anesthetics: Clinical Application as Spinal Anesthesia
1.3K
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...
1.3K
Parenteral Anesthetics: Overview
602
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.
602
Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia
1.9K
Depending on the target organ, local anesthetics (LAs) can be administered via various routes. In surface anesthesia, LAs are applied directly to the surface of the skin or mucous membranes. It is widely used for topical skin numbing before venipuncture or minor surgical procedures. Commonly used surface local anesthetics are lidocaine or benzocaine sprays or creams. Surface anesthesia occurs within 5 minutes and lasts for about 60 minutes. One of the main disadvantages of topical anesthesia is...
1.9K
Local Anesthetics: Common Agents and Their Applications
903
Local anesthetics (LAs) are commonly used for various applications in medical and dental procedures. Some of the common agents used are cocaine, lidocaine, and bupivacaine.
Cocaine is an ester of benzoic acid and methylecgogine. It is used to anesthetize and vasoconstrict locally. Currently, it is used primarily for topical applications. It is beneficial for surgeries on the upper respiratory tract, providing anesthesia and shrinking the mucosa. Cocaine in the form of cocaine hydrochloride is...
Cocaine is an ester of benzoic acid and methylecgogine. It is used to anesthetize and vasoconstrict locally. Currently, it is used primarily for topical applications. It is beneficial for surgeries on the upper respiratory tract, providing anesthesia and shrinking the mucosa. Cocaine in the form of cocaine hydrochloride is...
903
Depolarizing Blockers: Pharmocokinetics
567
Depolarizing blockers are administered through intravenous injection. Succinylcholine is the most common choice of depolarizing blockers in emergency clinical practices. Although they have a rapid onset, they readily diffuse away from the motor end plate into the extracellular fluid. They are metabolized by enzymes such as liver butyrylcholinesterase and plasma pseudocholinesterases. This produces a short duration of action, typically 5-10 minutes long, unlike nondepolarizing blockers, which...
567


