■阿片类药物被用作止痛药已有数千年的历史。然而,它们也可能引起不良的副作用。因此,我们进行了这项研究,以比较无阿片类药物麻醉(OFA)与阿片类药物保留麻醉(OSA)对术后疼痛和患者自控硬膜外镇痛(PCEA)相关事件的影响。
■这是一项单中心随机临床试验,招募了年龄在18至70岁之间的患者,他们在2021年10月至2022年2月之间接受了视频辅助肺手术。参与者被1:1随机分配到OFA或OSA。OFA组患者接受异丙酚,罗库溴铵,艾司洛尔,利多卡因,硫酸镁和硬膜外罗哌卡因静脉注射。OSA组患者接受异丙酚,罗库溴铵,瑞芬太尼,和舒芬太尼静脉注射硬膜外氢吗啡酮和罗哌卡因。
■总共124名患者被随机分配到OFA或OSA组。在OFA组中,术后第一天咳嗽时疼痛的严重程度(PODs;VAS评分1.88±0.88vs.2.16±1.1,p=0.044)明显低于OSA组。OFA组中PCEA相关不良事件的总比率[11(19.6%)与26(47.3%),p=0.003]显著低于OSA组。
■与OSA组患者相比,在接受电视辅助肺手术的患者中,OFA导致急性术后运动诱发疼痛的严重程度较低,并且与PCEA相关的不良事件较少。
■clinicaltrials.gov,标识符(NCT05063396)。
UNASSIGNED: Opioids have been used as pain relievers for thousands of years. However, they may also cause undesirable side effects. We therefore performed this
study to compare the effect of opioid-free anesthesia (OFA) versus opioid-sparing anesthesia (OSA) on postoperative pain and patient-controlled epidural analgesia (PCEA)-related events.
UNASSIGNED: This is a single center randomized clinical
trial that was recruited patients aged from 18 to 70 years who received video-assisted lung surgery between October 2021 and February 2022. Participants were 1:1 randomly assigned to OFA or OSA. Patients in the OFA group received propofol, rocuronium, esmolol, lidocaine, and magnesium sulfate intravenously with epidural ropivacaine. Patients in the OSA group received propofol, rocuronium, remifentanil, and sufentanil intravenously with epidural hydromorphone and ropivacaine.
UNASSIGNED: A total number of 124 patients were randomly allocated to the OFA or OSA group. In the OFA group, the severity of pain during coughs on the first postoperative days (PODs; VAS score 1.88 ± 0.88 vs. 2.16 ± 1.1, p = 0.044) was significantly lower than that in the OSA group. The total ratio of PCEA-related adverse events in the OFA group [11 (19.6%) vs. 26 (47.3%), p = 0.003] was significantly lower than in the OSA group.
UNASSIGNED: OFA in patients who received video-assisted lung surgery led to lower severity of acute postoperative motion-induced pain and fewer PCEA-related adverse events on the first POD than in the patients in the OSA group.
UNASSIGNED: clinicaltrials.gov, identifier (NCT05063396).