| 程少毅,陈 召,陈 静,周勇安,杨三虎,卢 强.超前镇痛对VATS肺叶切除患者阿片类药物使用的影响[J].,2020,(5):885-888 |
| 超前镇痛对VATS肺叶切除患者阿片类药物使用的影响 |
| Effect of Preemptive Analgesia on Opioid Consumption in Patients with VATS Lobectomy |
| 投稿时间：2019-09-23 修订日期：2019-10-18 |
| DOI：10.13241/j.cnki.pmb.2020.05.018 |
| 中文关键词: 电视辅助胸腔镜手术 超前镇痛 阿片类药物 |
| 英文关键词: Video-assisted thoracoscopic surgery Preemptive analgesia Opioids |
| 基金项目:国家自然科学基金项目(81572252) |
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| 中文摘要: |
| 摘要 目的：探讨术前应用对乙酰氨基酚和加巴喷丁对电视辅助胸腔镜肺叶切除患者术后阿片类药物使用、恶心呕吐的影响。方法：收集2016年1月至2018年12月因非小细胞肺癌就诊于我科行电视辅助胸腔镜肺叶切除的患者，收集患者临床资料包括年龄、性别、BMI、合并症、美国麻醉医师协会麻醉分级、肿瘤分级、肿瘤部位、手术时间，术中和术后阿片类药物使用情况、术后止吐药使用情况，阿片类药物使用均换算为口服吗啡当量，根据术前是否采用对乙酰氨基酚和加巴喷丁超前镇痛方案将患者分为两组，比较两组患者术前基本情况及术中术后阿片类药物使用情况，分析对乙酰氨基酚和加巴喷丁超前镇痛方案对阿片类药物使用情况的影响。结果：共有241例患者纳入研究，有78例患者术前采用对乙酰氨基酚和加巴喷丁超前镇痛方案，163例患者没有采用该镇痛方案，超前镇痛组患者术中及术后阿片类药物使用剂量、术后24小时呕吐次数、术后止吐药使用剂量均低于没有采用超前镇痛方案的患者，两组患者术后NSAIDs使用和镇静状态没有统计学差异。结论：术前采用对乙酰氨基酚和加巴喷丁超前镇痛方案可减少行电视辅助胸腔镜肺叶切除患者术中及术后阿片类药物使用剂量，降低术后恶心呕吐的发生。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effect of preoperative acetaminophen and gabapentin on opioid consumption and nausea and vomiting in patients undergoing video-assisted thoracoscopic lobectomy. Methods: Patients who underwent video-assisted thoracoscopic lobectomy for non-small cell lung cancer from January 2016 to December 2018 were enrolled. Clinical data were collected including age, gender, BMI, comorbidities, anesthesia classification of American Society of Anesthesiologists, Tumor grading, tumor location, surgery time, intraoperative and postoperative opioid consumption, postoperative antiemetic application, opioid consumption was converted to oral morphine equivalent. Patients were divided into two groups according to whether preoperative analgesic regimen with acetaminophen and gabapentin was used. The preoperative basic conditions and the use of opioids during and after surgery were compared between the two groups. The effects of acetaminophen and gabapentin preemptive analgesia regimen on the use of opioids were analyzed. Results: A total of 241 patients were included in the study. 78 patients underwent preoperative analgesic regimen with acetaminophen and gabapentin, and 163 patients did not take this analgesic regimen. The doses of opioids, number of vomiting in 24 hours after surgery, and postoperative antiemetic in patients with preemptive analgesia were lower than those without preemptive analgesia. There was no significant difference in postoperative NSAIDs usage and sedation between the two groups. Conclusion: Preoperative analgesic regimen with acetaminophen and gabapentin can reduce the dose of opioids during and after surgery for patients undergoing video-assisted thoracoscopic lobectomy, and reduce postoperative nausea and vomiting. |
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