在腹腔镜肝切除术中以乙胺为基础的无阿片类药物麻醉的血液动力学影响:一项随机临床试验
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Updated: Jan 11, 2026
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Application of Hemostatic Devices in Laparoscopic Hepatectomy
Published on: April 19, 2022
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Yiting Yao1, Siqi Yang1, Yidong Xu1
1Department of Anesthesiology and Perioperative Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
International journal of surgery (London, England)
|November 11, 2025
概括
基于esketamine的无阿片类药物麻醉 (OFA) 改善了 laparoscopic hepatectomy 在受控的中央静脉低压 (CLVCP) 期间的血液动力稳定性. 与传统的阿片类麻醉相比,这种方法可以减少血压波动和血管压缩剂的需求.
科学领域:
- 麻醉学 麻醉学
- 肝胆道手术 肝胆道手术
- 血液动力学 血液动力学
背景情况:
- 建议对腹腔镜肝切除术进行控制的低中心静脉压 (CLVCP).
- 在CLVCP条件下对血动力学稳定性和安全性进行评估,对以斯基坦胺为基础的无阿片类麻醉 (OFA) 非常重要.
研究的目的:
- 评估基于乙胺的OFA在CLVCP下腹腔镜肝切除术期间对血液动力稳定性的影响.
- 将OFA与包括阿片类药物在内的麻醉与外科手术期间的安全性和血管压缩剂要求进行比较.
主要方法:
- 一项前性,随机,双盲,受控试验,涉及146名接受腹腔镜肝切除术的患者.
- 患者在CLVCP管理下接受了基于乙胺的OFA或包括阿片类药物的麻醉.
- 主要结局:普林格尔机动释放后的平均动脉压变化.
主要成果:
- 没有阿片类药物的麻醉组在普林格尔机动释放后显示出明显较小的平均动脉压降低 (0.8 mmHg vs 12.5 mmHg).
- 在OFA组中观察到较轻的血压波动和显著较低的手术内血管压缩剂需求.
- 这些发现具有统计学意义 (P < 0.001).
结论:
- 基于esquetamine的OFA增强了CLVCP的腹腔镜肝切除术中的手术内血动力学稳定性.
- OFA减少了血管压缩剂的需求,支持其在肝胆外科手术的增强恢复方案中使用.
- 无阿片类药物麻醉是一种可行的替代阿片类药物包括策略.
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