整形外科手术中的外科手术甲:一个范围审查
Albert F Yang1, Emily Lee1, Mahsa Babaei1
1Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA.
Healthcare (Basel, Switzerland)
|October 16, 2025
概括
术内甲有效减少术后疼痛和阿片类药物使用,特别是在脊柱手术中. 它的有效性因程序而异,需要进一步的研究才能在骨科疼痛管理中得到最佳使用.
科学领域:
- 麻醉学和疼痛管理
- 整形外科手术 整形外科手术
- 药理学 药理学是指药理学的学科.
背景情况:
- 骨科手术中的术后疼痛管理通常依赖于阿片类药物.
- 作为辅助止痛药的手术内甲的作用正在调查中.
- 评估甲对骨科疼痛的有效性和安全性至关重要.
研究的目的:
- 对骨科手术中手术内甲的文献进行范围审查.
- 综合关于疼痛评分,阿片类药物消费和不良影响的发现.
- 评估术后甲治疗术后疼痛的疗效和安全性.
主要方法:
- 对Medline,PubMed和Scopus数据库 (2000-2025) 的范围审查.
- 纳入标准:手术内甲,骨科手术,报告结果.
- 对13项选定的研究进行了定性综合.
主要成果:
- 在成年脊椎手术中,手术内甲 (0.2 mg/kg) 显著降低了术后阿片类药物消耗 (高达 50%) 和疼痛评分 (高达 72h).
- 与美沙的多式疗法在儿科脊椎手术中减少了多达76%的阿片类药物使用.
- 在关节镜膝关节手术中,吗啡优于甲;安全性是可以接受的.
结论:
- 术后甲是一种有效的止痛辅助剂,可以减少疼痛和阿片类药物需求,在多式模式策略中的重大脊柱手术中.
- 甲的有效性取决于环境,在整形外科手术中有所不同.
- 需要进一步的研究来优化剂量和定义其在各种骨科手术中的作用.
相关概念视频
Opioid Analgesics: Synthetic and Semisynthetic Opioids
908
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...
908
Opioid Analgesics: Morphine and Other Natural Cogeners
848
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...
848
Analgesia and Pain Management
1.5K
Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
1.5K
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
551
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
551
Parenteral Anesthetics: Overview
574
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.
574
Cardiomyopathy VII: Pre and Post Operative Nursing Management
283
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
283


