度洛西汀和地塞米松改善腹腔镜妇科手术术后疼痛：随机临床试验
本公众号每天分享一篇最新一期Anesthesia & Analgesia等SCI杂志的摘要翻译，敬请关注并提出宝贵意见
Impact of duloxetine and dexamethasone for improving
postoperative pain after laparoscopic gynecological surgeries: A randomized clinical trial
背景与目的
患者的手术体验，受到痛苦管理观念的影响。 度洛西汀（Dulox）和地塞米松（Dex）可用于多模式镇痛以减少阿片类药物的使用和副作用。 Dulox是一种选择性5-羟色胺和去甲肾上腺素再摄取抑制剂，对慢性疼痛有效。 Dex增强术后镇痛并减少术后恶心呕吐（PONV）。
方 法
七十五岁的女性患者，随机分为3组。GI组在15分钟内口服Dulox 60mg和100ml 0.9％氯化钠静脉输注，GII：除了Dex 0.1mg / kg与NS混合，其他与GI组相同。GIII术前2 h接受相同的安慰剂 Dulox胶囊和Dex静脉注射。 术后30 min，1 h，2 h，6 h和12 h评估患者的生命质量、视觉模拟评分（VAS）和镇静评分。 记录总哌替啶需要量，血浆皮质醇，PONV和患者满意度。
结 果
术后止疼时间：GI和GII组相比GIII组明显较长，GII比GI明显较长。术后 30 分钟, GI and GII与GIII相比，1, 2, 6小时VAS评分、心率、平均动脉压力明显更低，镇静评分更高。在术后12 h，GI和GII与GIII相比，杜冷丁的总需求明显减少。GI and GII与GIII相比，血浆皮质醇明显降低，患者满意度升高。GII相比GI和GIII PONY发生明显减少。
结 论
通过减少镇痛药的使用，改善术后疼痛和PONV，术前2 h口服Dulox
60 mg联合Dex 0.1 mg / kg IVI比口服Dulox 60 mg更有效。
原始文献摘要
Dina Y. Kassim, Ibrahim M. Esmat, Mohammed A. Elgendy；Impact of duloxetine and dexamethasone for improving postoperative pain after laparoscopic gynecological surgeries: A randomized clinical trial；Downloaded free from http://www.saudija.org on Thursday, February 1, 2018, IP: 177.237.182.138
Background: Patients’ surgical experiences are influenced by their perception of pain management. Duloxetine (Dulox) and dexamethasone (Dex) are used in multimodal analgesia to reduce opioid use and side effects. Dulox is a selective serotonin and norepinephrine reuptake inhibitor and has efficacy in chronic pain conditions. Dex enhances postoperative (PO) analgesia and reduces PO nausea and vomiting (PONV).
Methods: Seventy‑five female patients were randomly allocated into one of three equal groups. GI received Dulox 60 mg orally and 100 ml 0.9% sodium chloride (normal saline [NS]) intravenous infusion (IVI) over 15 min, GII: received as GI except Dex 0.1 mg/kg was mixed with NS and GIII received identical placebo for Dulox capsule and Dex IVI, 2 h preoperatively. Patients’
vitals, visual analog scale (VAS), and sedation score were assessed at 30 min, 1 h, 2 h, 6 h, and 12 h postoperatively. Total pethidine requirements, plasma cortisol, PONV, and patients satisfaction were recorded.
Results: PO time for 1st rescue analgesic was significantly high in GI and GII compared to GIII and in GII compared to GI. There was a significant less VAS score, heart rate, mean arterial pressure, and a high sedation score in GI and GII compared to GIII at 30 min, 1, 2, and 6 h postoperatively. Total pethidine requirements were significantly less in GI and GII compared to GIII 12 h postoperatively. There was a significant reduction in the 2 h PO serum cortisol (μg/dl) and a significant increase in the PO patients satisfaction score in GI and GII compared to GIII. PONV was decreased significantly in GII compared to GI and GIII.
Conclusion: The use of oral Dulox 60 mg combined with Dex 0.1 mg/kg IVI is more effective than oral Dulox 60 mg alone, 2 h preoperatively, for improving PO pain by reducing the requirements for rescue analgesia and PONV.
麻醉学文献进展分享
联系我们