评估无阿片类药物麻醉结合术前胸椎旁阻滞和术后静脉注射患者自控镇痛剂羟考酮与非阿片类药物镇痛剂在视频辅助胸腔手术围手术期麻醉管理中的可行性。

IF 1.6 Q2 ANESTHESIOLOGY Anaesthesiology intensive therapy Pub Date : 2024-01-01 DOI:10.5114/ait.2024.141279
Maja Magdalena Copik, Dominika Sadowska, Jacek Smereka, Damian Czyzewski, Hanna Dorota Misiołek, Szymon Białka
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引用次数: 0

摘要

导言:本研究于 2015 年 12 月至 2018 年 3 月期间在一家大学医院进行,探讨了对接受选择性视频辅助胸腔镜手术(VATS)的患者进行无阿片麻醉联合术前胸椎旁阻滞(ThPVB)的可行性和安全性。目的是评估这种方法对术后疼痛程度和阿片类药物消耗量的影响:64名计划接受择期VATS手术的患者被随机分配到干预组(接受ThPVB无阿片麻醉)或对照组(接受标准全身麻醉)。术后,两组患者均接受羟考酮患者自控镇痛和非阿片类镇痛药。疼痛强度采用数字疼痛评分量表(NRS)和亨利王子医院疼痛评分(PHHPS)进行测量。24 小时随访期间记录了术后使用羟考酮的总剂量以及阿片类药物相关不良事件的发生情况:结果:与对照组相比,干预组患者在术后 20 小时和 24 小时的疼痛程度明显降低(分别为 P = 0.015 和 P = 0.021)。值得注意的是,对照组 24 小时的羟考酮用量明显高于干预组(P < 0.0001)。研究期间未发现严重不良事件:这项研究证明了无阿片麻醉结合 ThPVB 用于择期 VATS 的可行性和安全性。该方法大大减少了术后疼痛和对阿片类药物的需求,支持其作为一种有效、平衡的围手术期麻醉策略的潜力。
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Assessment of feasibility of opioid-free anesthesia combined with preoperative thoracic paravertebral block and postoperative intravenous patient-controlled analgesia oxycodone with non-opioid analgesics in the perioperative anesthetic management for video-assisted thoracic surgery.

Introduction: This study, conducted between December 2015 and March 2018 at a single university hospital, explored the feasibility and safety of opioid-free anesthesia combined with preoperative thoracic paravertebral block (ThPVB) for patients undergoing elective video-assisted thoracoscopic surgery (VATS). The aim was to assess the impact of this approach on postoperative pain levels and opioid consumption.

Material and methods: Sixty-four patients scheduled for elective VATS were randomly assigned to either the intervention group, receiving opioid-free anesthesia with ThPVB, or the control group, managed with standard general anesthesia. Postoperatively, both groups received oxycodone patient-controlled analgesia along with non-opioid analgesics. Pain intensity was measured using the Numeric Pain Rating Scale (NRS) and Prince Henry Hospital Pain Score (PHHPS). The total dose of postoperative oxycodone and the occurrence of opioid-related adverse events were recorded during the 24-hour follow-up period.

Results: Patients in the intervention group showed significantly lower pain levels at 20 and 24 hours post-procedure ( P = 0.015, P = 0.021, respectively) compared to the control group. Notably, oxycodone consumption at 24 hours was significantly higher in the control group ( p < 0.0001). No serious adverse events were observed during the study period.

Conclusions: This study demonstrates the feasibility and safety of opioid-free anesthesia combined with ThPVB for elective VATS. The approach significantly reduces postoperative pain and the need for opioids, supporting its potential as an effective and balanced perioperative anesthetic strategy.

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来源期刊
CiteScore
3.00
自引率
5.90%
发文量
48
审稿时长
25 weeks
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