脂质组布皮瓦卡因与德克萨米他的罗皮瓦卡因相比,用于拉巴洛斯科普胃切除术的直肠膜块:随机对照试验
Kun Yi1, Yanping Zhan1, Aiping Wei1
1Department of Anesthesiology, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, People's Republic of China.
Drug design, development and therapy
|March 4, 2026
概括
超声波引导的直肠膜阻塞与脂质体布皮瓦卡因在腹腔镜胃切除术后提供卓越的疼痛缓解和减少阿片类药物的使用. 与单独的脂质体布皮瓦卡因相比,添加德克萨没有提供额外的止痛益处.
科学领域:
- 麻醉学 麻醉学
- 术后恢复 术后恢复
- 疼痛管理 疼痛管理
背景情况:
- 腹腔镜胃切除术后的最佳止痛仍然没有确定.
- 这项研究研究了使用脂质体布皮瓦卡因用于增强恢复的超声导向直肠阻塞 (RSB).
研究的目的:
- 为了评估超声导向RSB与脂质体布皮瓦卡因在持续疼痛缓解方面的疗效.
- 为了比较脂质体布皮瓦卡因 (有或没有德克萨米) 与罗皮瓦卡因-德克萨米用于术后疼痛控制.
主要方法:
- 经过腹腔镜胃切除术的102名患者被随机分为三个组:罗皮瓦卡因 - 德萨梅他松 (RD),脂质体布皮瓦卡因 (LB) 和脂质体布皮瓦卡因 - 德萨梅他松 (LBD).
- 主要结局是手术后72小时的阿片类药物消费 (MME). 二级结局包括疼痛评分,恢复质量 (QoR-15),满意度,炎症标志物和停留时间.
主要成果:
- 与RD组相比,脂质体布皮瓦卡因组 (LB和LBD) 的阿片类药物消费和疼痛得分显著降低.
- 在手术后24小时,LB和LBD组显示IL-1β和IL-6水平降低.
- 在LB和LBD组之间没有观察到任何显著差异,这表明添加德克萨没有提供额外的益处.
结论:
- 超声波引导的RSB与脂质体布皮瓦卡因提供优异的止痛作用,并减少阿片类药物的消耗,直到48小时后的laparoscopic胃切除术.
- 将德克萨米他添加到脂质体布皮瓦卡因并没有增强镇痛效果.
- 脂质体布皮瓦卡因是胃切除术患者术后疼痛管理的有效选择.
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