Intraoperative Non-Opiate Anesthesia for Patients Undergoing Arthroscopic Temporomandibular Joint Surgery: A Randomized Controlled Trial.

IF 4.7 2区医学 Q1 CHEMISTRY, MEDICINAL

Drug Design, Development and Therapy Pub Date : 2024-11-04 eCollection Date: 2024-01-01 DOI:10.2147/DDDT.S486134

He Ma, Juan Perez, Julia Bertsch, Marissa L Albanese, Elizabeth G Korn, Ariel Mueller, Timothy Houle, Briana June Burris, Joseph McCain, Jingping Wang

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引用次数: 0

Abstract

Background: Pain intensity after temporomandibular joint (TMJ) surgery is often underestimated, and inadequate pain control may relate to poor recovery quality, increased opioid consumption, and longer hospital stay. This trial aims to evaluate whether non-opiate anesthesia provides a promising option of pain management for patients undergoing TMJ surgery.

Methods: Sixty patients receiving TMJ surgery were randomly assigned to either the control group or the non-opiate group. Non-opiate anesthesia used lidocaine, dexmedetomidine, and ketamine infusion therapy for pain management. The primary outcome was the highest documented pain score while in the post-anesthesia care unit (PACU). Secondary outcomes included perioperative opioid consumption, utilization, dosage, and timing of rescue analgesia in the PACU, incidence of postoperative nausea and vomiting in the PACU and at home, pain satisfaction levels, occurrence of opioid-related adverse effects, duration of PACU and hospital stays, and total consumption of oxycodone-acetaminophen tablets at 24 and 48 hours post-surgery.

Results: Patients were predominantly female (88.3%) and had a median age of 37.5 [IQR 26.0, 52.5] years. There were no significant differences observed in the highest documented pain scores (mean difference [MD] -0.36 points, 95% CI: -1.84, 1.12, p = 0.63), postoperative oxycodone-acetaminophen consumption (MD 6.68 mg, 95% CI: -2.48, 15.84, p = 0.15), pain satisfaction (odds ratio [OR] 0.81, 95% CI: 0.23, 2.81, p = 0.74), time to PACU discharge (hazard ratio [HR] 1.24, 95% CI: 0.67, 2.30, p = 0.49) or time to hospital discharge (HR 1.48, 95% CI: 0.80, 2.75, p = 0.21) between the two groups. Similarly, no significant difference was observed in time to rescue analgesia, calculated in minutes from the end of surgery (HR 1.69, 95% CI: 0.79, 3.61, p = 0.18).

Conclusion: Non-opiate anesthesia for pain management shows a similar postoperative analgesia effect, compared to opioid-based anesthesia, in patients undergoing arthroscopic TMJ surgery.

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颞下颌关节镜手术患者的术中非阿片类麻醉：随机对照试验

背景：颞下颌关节（TMJ）手术后的疼痛强度往往被低估，疼痛控制不当可能导致恢复质量差、阿片类药物用量增加和住院时间延长。本试验旨在评估非阿片类麻醉是否能为接受颞下颌关节手术的患者提供一种可行的疼痛控制方法：方法：60 名接受颞下颌关节手术的患者被随机分配到对照组或非掺入麻醉组。非副作用麻醉使用利多卡因、右美托咪定和氯胺酮输注疗法进行疼痛控制。主要结果是在麻醉后护理病房（PACU）期间记录的最高疼痛评分。次要结果包括围手术期阿片类药物的用量、使用情况、剂量以及在 PACU 进行抢救性镇痛的时间、在 PACU 和家中术后恶心和呕吐的发生率、疼痛满意度、阿片类药物相关不良反应的发生率、PACU 和住院时间以及术后 24 小时和 48 小时羟考酮-对乙酰氨基酚片剂的总用量：患者主要为女性（88.3%），中位年龄为 37.5 [IQR 26.0, 52.5]岁。在记录的最高疼痛评分（平均差[MD] -0.36分，95% CI：-1.84，1.12，P = 0.63）、术后羟考酮-对乙酰氨基酚消耗量（MD 6.68毫克，95% CI：-2.48，15.84，P = 0.15）、疼痛满意度（几率比 [OR] 0.81，95% CI：0.23，2.81，P = 0.74）、PACU 出院时间（危险比 [HR]1.24，95% CI：0.67，2.30，P = 0.49）或出院时间（HR 1.48，95% CI：0.80，2.75，P = 0.21）在两组之间无显著差异。同样，以手术结束后几分钟为单位计算的镇痛抢救时间也无明显差异（HR 1.69，95% CI：0.79，3.61，P = 0.18）：结论：在接受颞下颌关节镜手术的患者中，非阿片类麻醉与阿片类麻醉的术后镇痛效果相似。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Drug Design, Development and Therapy CHEMISTRY, MEDICINAL-PHARMACOLOGY & PHARMACY

CiteScore

9.00

自引率

0.00%

发文量

382

审稿时长

>12 weeks

期刊介绍： Drug Design, Development and Therapy is an international, peer-reviewed, open access journal that spans the spectrum of drug design, discovery and development through to clinical applications. The journal is characterized by the rapid reporting of high-quality original research, reviews, expert opinions, commentary and clinical studies in all therapeutic areas. Specific topics covered by the journal include: Drug target identification and validation Phenotypic screening and target deconvolution Biochemical analyses of drug targets and their pathways New methods or relevant applications in molecular/drug design and computer-aided drug discovery* Design, synthesis, and biological evaluation of novel biologically active compounds (including diagnostics or chemical probes) Structural or molecular biological studies elucidating molecular recognition processes Fragment-based drug discovery Pharmaceutical/red biotechnology Isolation, structural characterization, (bio)synthesis, bioengineering and pharmacological evaluation of natural products** Distribution, pharmacokinetics and metabolic transformations of drugs or biologically active compounds in drug development Drug delivery and formulation (design and characterization of dosage forms, release mechanisms and in vivo testing) Preclinical development studies Translational animal models Mechanisms of action and signalling pathways Toxicology Gene therapy, cell therapy and immunotherapy Personalized medicine and pharmacogenomics Clinical drug evaluation Patient safety and sustained use of medicines.