结合贝他美和罗皮瓦卡因用于头皮神经阻塞,用于接受选择性切割的患者:一项前性,随机的,受控的临床研究
Jiazheng Qi1, Lingqi Gao1, Wenru Zong1
1Department of Anesthesiology, Huashan Hospital, Fudan University, Shanghai.
Journal of neurosurgical anesthesiology
|December 10, 2025
概括
在头皮神经阻塞中添加贝他他和罗皮瓦卡因可显著降低骨切割患者的术后疼痛. 与单独的罗皮瓦卡因相比,这种组合提供了长时间的止痛,并降低了炎症标志物.
科学领域:
- 神经外科 神经外科
- 麻醉学 麻醉学
- 疼痛管理 疼痛管理
背景情况:
- 头皮神经阻断 (SNB) 对于神经外科恢复至关重要,但仅用局部麻醉剂就能提供有限的疼痛缓解.
- 贝塔梅他和罗皮瓦卡因的组合正在探索骨切除术后延长疼痛缓解.
研究的目的:
- 评估在SNB中将贝他他松与罗皮瓦卡因结合使用是否会延长术后止痛,与单独使用罗皮瓦卡因相比.
- 评估这种组合对疼痛评分和炎症标志物的影响.
主要方法:
- 这是一项前性随机对照试验,涉及90名接受选择性切割的患者.
- 患者接受了0.5%的罗皮瓦卡因加贝他马松或0.5%的单独罗皮瓦卡因的SNB.
- 主要结局:术后48小时的数值评分表 (NRS) 疼痛评分;次要结局:48小时内NRS评分和血细胞因子水平 (IL-6,IL-10,IFN-γ).
主要成果:
- 贝塔梅他组在48小时内显示出明显较低的NRS疼痛得分 (1对2,P<0.001),并在24小时内改善得分.
- 在甲组中观察到更低的互白素-6 (P=0.001) 和干扰素- (P=0.042) 度.
- 两组之间没有发现白蛋白-10度的显著差异 (P=0.582).
结论:
- 贝塔梅他与0.5%的罗皮瓦卡因SNB相结合,有效地减少了手术后48小时和24小时内的疼痛强度.
- 增强的止痛效应很可能归因于长时间的麻醉效应和炎症反应的减少.
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