剖腹产后的利多卡因贴片:随机对照试验的元分析
Nadia Parisi1, Alessandro Petrecca2, Whitney Bender3
1Obstetric-Gynecologic Unit (Parisi), General Regional Hospital "F. Miulli", Bari, Italy.
American journal of obstetrics & gynecology MFM
|November 15, 2025
概括
利多卡因贴片在剖腹产后36小时内显著降低了疼痛评分. 这次元分析发现,与安慰剂相比,晚期疼痛,阿片类药物使用或不良反应没有差异.
科学领域:
- 产科和妇科 产科和妇科
- 麻醉学 麻醉学
- 疼痛管理 疼痛管理
背景情况:
- 剖腹产是一种常见的外科手术手术.
- 术后疼痛管理对于患者的康复至关重要.
- 需要有效的止痛策略来改善结果.
研究的目的:
- 评估利多卡因贴片在剖腹产后进行术后疼痛缓解的疗效和安全性.
- 为了比较利多卡因贴片使用与安慰剂在随机对照试验 (RCT) 的元分析.
主要方法:
- 三个涉及219个怀孕的RCT的元分析.
- 主要结局:剖腹产后24小时的疼痛 (视觉模拟尺度 - VAS).
- 二次结果:其他时间点的疼痛,阿片类药物消费和不良反应.
主要成果:
- 与安慰剂相比,利多卡因贴片在剖腹产后12,24和36小时显著降低了VAS疼痛评分.
- 在48小时和72小时的VAS得分中没有发现显著差异.
- 在利多卡因贴片和安慰剂组之间,阿片类药物的消费和不良反应是相似的.
结论:
- 利多卡因贴片在剖腹产后的早期术后疼痛减轻方面表现出有效性.
- 利多卡因贴片的使用可以被视为多模式止痛策略的组成部分.
- 利多卡因贴片在剖腹产后使用似乎是安全的,没有增加不良事件.
相关概念视频
Local Anesthetics: Clinical Application as Epidural Anesthesia
677
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...
677
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
Local Anesthetics: Common Agents and Their Applications
874
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...
874
Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia
1.8K
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...
1.8K
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
1.1K
Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
One of the advantages of...
1.1K
Local Anesthetics: Differential Sensitivity of Nerve Fibers
1.3K
Local anesthetics (LAs) block the sodium channels of nerve trunks, sensory nerve endings, and neuromuscular junctions. Although LAs can block all kinds of nerves, the sensitivity of nerve fibers differs according to nerve types and structures. LAs are known to block myelinated fibers faster than unmyelinated ones. Also, they block pain or sensory neurons at low concentrations without affecting the motor neurons involved in muscle contractions. This helps relieve labor pain without affecting the...
1.3K


