首页> 外文期刊>Frontiers in Pharmacology >The Opioid-Sparing Effect of Perioperative Dexmedetomidine Plus Sufentanil Infusion during Neurosurgery: A Retrospective Study
【24h】

The Opioid-Sparing Effect of Perioperative Dexmedetomidine Plus Sufentanil Infusion during Neurosurgery: A Retrospective Study

机译:围手术期右美托咪定加舒芬太尼输注的阿片类药物在神经外科手术中的效果:回顾性研究

获取原文
           

摘要

Background: Approximately 60% of patients experience moderate-to-severe pain after neurosurgery, which primarily occurs in the first 24–72 h. Despite this, improved postoperative analgesia solutions after neurosurgery have not yet been devised. This retrospective study was conducted to evaluate the effect of intra- and post-operative infusions of dexmedetomidine (DEX) plus sufentanil on the quality of postoperative analgesia in patients undergoing neurosurgery. Methods: One hundred and sixty-three post-neurosurgery patients were divided into two groups: Group D (DEX infusion at 0.5 μg·kg~(?1)for 10 min, then adjusted to 0.3 μg·kg~(?1)·h~(?1)until incision suturing) and Group ND (no DEX infusion during surgery). Patient-controlled analgesia was administered for 72 h after surgery (Group D: sufentanil 0.02 μg·kg~(?1)·h~(?1)plus DEX 0.02 μg·kg~(?1)·h~(?1), Group ND: sufentanil 0.02 μg·kg~(?1)·h~(?1)) in this retrospective study. The primary outcome measure was postoperative sufentanil consumption. Hemodynamics, requirement of narcotic, and vasoactive drugs, recovery time and the incidence of concerning adverse effects were recorded. Pain intensity [Visual Analogue Scale (VAS)], Ramsay sedation scale (RSS) and Bruggemann comfort scale (BCS) were also evaluated at 1, 4, 8, 12, 24, 48, and 72 h after surgery. Results: Postoperative sufentanil consumption was significantly lower in Group D during the first 72 h after surgery ( P < 0.05). Compared with Group ND, heart rate (HR) in Group D was significantly decreased from intubation to 20 min after arriving at post anesthesia care unit (PACU), while mean arterial pressure (MAP) in Group D was significantly decreased from intubation to 5 min after arriving at PACU ( P < 0.05). The intraoperative requirements for sevoflurane, remifentanil, and fentanyl were approximately 35% less in Group D compared with Group ND. VAS at rest at 1, 4, and 8 h and with cough at 12, 24, 48, and 72 h after surgery were significantly lower in Group D ( P < 0.05). Compared with Group ND, patients in Group D showed lower levels of overall incidence of tachycardia, hypertension, nausea, and vomiting ( P < 0.05). There were no significant differences between the two groups in terms of baseline clinical characteristics, recovery time, RSS, and BCS ( P > 0.05). Conclusions: DEX (0.02 μg·kg~(?1)·h~(?1)) plus sufentanil (0.02 μg·kg~(?1)·h~(?1)) could reduce postoperative opioid consumption and concerning adverse adverse effects, while improving pain scores. However, it did not influence RSS and BCS during the first 72 h after neurosurgery.
机译:背景:大约60%的患者在神经外科手术后经历中度至重度疼痛,这种疼痛主要发生在最初的24-72小时内。尽管如此,神经外科手术后仍未设计出改善术后镇痛的方法。这项回顾性研究旨在评估右美托咪定(DEX)和舒芬太尼在术中和术后输注对神经外科患者术后镇痛质量的影响。方法:163例神经外科手术后患者分为两组:D组(DEX以0.5μg·kg〜(?1)输注10分钟,然后调整至0.3μg·kg〜(?1)·)。 h〜(?1)直到切口缝合)和ND组(手术期间不进行DEX输注)。术后自控镇痛72 h(D组:舒芬太尼0.02μg·kg〜(?1)·h〜(?1)加DEX 0.02μg·kg〜(?1)·h〜(?1) ,ND组:舒芬太尼0.02μg·kg〜(?1)·h〜(?1))。主要结局指标是术后服用舒芬太尼。记录血流动力学,麻醉药和血管活性药物的需求量,恢复时间和相关不良反应的发生率。还在手术后1、4、8、12、24、48和72小时评估疼痛强度[视觉模拟量表(VAS),拉姆齐镇静量表(RSS)和布鲁格曼舒适量表(BCS)。结果:D组术后72 h术后舒芬太尼的消耗量显着降低(P <0.05)。与ND组相比,到达麻醉后监护单元(PACU)后,D组的心率(HR)从插管降低到20分钟,而D组的平均动脉压(MAP)从插管降低到5分钟。到达PACU后(P <0.05)。与ND组相比,D组的七氟醚,瑞芬太尼和芬太尼的术中需要量减少了约35%。 D组术后1、4、8 h静息时的VAS以及术后12、24、48和72 h咳嗽的VAS显着降低(P <0.05)。与ND组相比,D组患者的心动过速,高血压,恶心和呕吐的总体发生率较低(P <0.05)。两组在基线临床特征,恢复时间,RSS和BCS方面无显着差异(P> 0.05)。结论:DEX(0.02μg·kg〜(?1)·h〜(?1))加上舒芬太尼(0.02μg·kg〜(?1)·h〜(?1))可以减少术后阿片类药物的消耗并引起不良不良反应效果,同时改善疼痛评分。但是,它在神经外科手术后的最初72小时内不影响RSS和BCS。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱:kefu@zhangqiaokeyan.com

京公网安备:11010802029741号 ICP备案号:京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有
  • 客服微信

  • 服务号