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在手术期间使用IV式德克萨米他可以更有效地减少手术后的疼痛吗?使用非阿片类药物或阿片类药物?

Ryan Look¹, Vincent B Ziccardi², Tracy Andrews³

¹Resident, Department of Oral and Maxillofacial Surgery, Rutgers School of Dental Medicine, Newark, NJ.

Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons

|November 7, 2025

概括

术中使用的皮质类固醇在第三手术后显著降低了术后疼痛,特别是与非阿片类止痛药结合使用时. 德甲在阿片类药物和非阿片类药物组中改善了疼痛控制,这表明它可以纳入疼痛管理策略.

科学领域:

口腔和牙面部外科手术
麻醉学麻醉学
药理学药理学是指药理学的学科.

背景情况:

已知皮质类固醇可以减少术后的胀和三症.
皮质类固醇在疼痛管理中的有效性,特别是与不同类型的止痛药 (阿片类与非阿片类) 结合使用,需要进一步研究.

研究的目的:

为了评估手术内皮质类固醇对第三手术后术后疼痛的影响.
为了比较皮质类固醇与非阿片类止痛药 (NSAID,乙氨基) 与阿片类止痛药一起使用时的止痛作用.

主要方法:

对1774名接受第三手术的患者进行了回顾性队列研究.
主要预测变量包括止痛治疗 (阿片类或非阿片类) 和手术内类固醇使用.
疼痛水平在术后第一,第二和第三天使用数值评分尺度进行评估,并使用混合效应模型进行统计分析.

主要成果:

在非阿片类药物和阿片类药物组中,在术后第一天内,手术期间使用类固醇与明显较低的疼痛评分有关.
非阿片类止痛药组与手术内类固醇结合,在所有测量日内表现出最低的整体疼痛得分.
服用类固醇可以改善疼痛控制,而不管使用了哪种止痛药.

结论:

在外科手术期间,静脉注射德克萨米他有效地减少了第三手术后的急性术后疼痛.
当与非阿片类或阿片类止痛药一起使用时,甲可增强疼痛控制.
这些发现支持将手术内静脉注射的德克萨米他与标准的术后非类固醇抗炎药物和乙氨基结合起来,以改善疼痛控制.

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