在ENT手术中以瞳孔疼痛指数为指导的术后疼痛治疗:一项随机试验
Marita Windpassinger1,2,3, Michal Prusak4, Lusine Yeghiazaryan5
1Department of Anesthesia, Intensive Care Medicine and Pain Medicine, Division of Pain Medicine, Medical University of Vienna, 1090 Vienna, Austria.
Journal of clinical medicine
|January 28, 2026
概括
以瞳孔疼痛指数为指导的止痛疗法显示出降低术后阿片类药物使用和疼痛的潜力. 虽然这种方法在统计学上并不显著,但它为个性化疼痛管理提供了对标准护理的有希望的替代方案.
科学领域:
- 麻醉学 麻醉学
- 疼痛管理 疼痛管理
- 眼科医生 眼科 眼科
背景情况:
- 术后疼痛和阿片类药物需求在患者之间有很大的差异.
- 瞳孔疼痛指数 (PPI) 测量了感觉-反感觉平衡,可能有助于个性化止痛.
- 个性化疼痛管理策略对于优化患者的治疗结果至关重要.
研究的目的:
- 为了测试以瞳孔疼痛指数为指导的阿片类药物定位是否与标准护理相比降低了术后疼痛和阿片类药物消耗.
- 评估瞳孔计在指导术后止痛的疗效.
- 为了确定PPI导向治疗是否可以个性化手术后的阿片类药物管理.
主要方法:
- 接受选择性耳鼻喉手术的成年患者被随机分为两组:PPI引导的阿片类药物治疗和标准护理.
- 瞳孔膨胀反射在动刺激期间使用红外瞳孔测量测量,以计算PPI得分.
- 在术后的阿片类药物消耗和疼痛 (数值评分表) 在麻醉后护理单位记录了2小时.
主要成果:
- 与对照组相比,PPI指导的组显示阿片类药物消费量减少了近25% (4.9毫克 vs 6.5毫克).
- 在PPI指导组 (2.0对2.6) 中,术后疼痛平均得分较低,尽管在统计学上不显著.
- 虽然趋势有利于PPI导向的方法,但对于疼痛或阿片类药物消费没有达到统计显著性 (分别为p=0.10和p=0.12).
结论:
- 以瞳孔疼痛指数为指导的止痛疗法显示了减少阿片类药物消费和术后降低疼痛评分的趋势.
- 这项研究表明,PPI引导的止痛疗法与治疗术后疼痛的标准护理并无劣势.
- 可能需要进一步的研究来证实PPI引导的疼痛管理的临床效用和统计学意义.
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