宫颈癌近距离治疗门诊的脊髓麻醉行走时间:5 毫克高压布比卡因芬太尼与 2.5 毫克高压布比卡因和 25 微克芬太尼的比较

Rica Dm, Mafiana R, Zainal R, Bahar E
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摘要

在门诊麻醉的实践中,区域麻醉技术和局麻已被证明比全身麻醉更有效。脊髓麻醉是宫颈癌近距离放疗患者门诊麻醉的首选技术。小剂量局麻药可加快下床时间。本研究旨在比较低剂量脊髓麻醉与常规剂量脊髓麻醉下床时间。快速的行走时间可以加快患者的恢复时间,从而减少患者的住院时间。方法:该研究是一项双盲,随机对照试验,于2022年8月至9月在Palembang Dr. Mohammad Hoesin General Hospital (RSMH)放射治疗装置进行。所有ASA I-II体质的成人宫颈癌患者接受近距离放疗均纳入研究样本。样本将被随机分为两组,一组是高压布比卡因5毫克和芬太尼25微克,另一组是布比卡因2.5毫克和芬太尼25微克。有过敏、运动功能受损、脊柱衰竭、未达到阻滞水平、休克、呼吸暂停、呼吸抑制和在手术过程中出现疼痛的患者被排除在研究之外。结果:高压布比卡因5 mg和25 mcg芬太尼组的下床时间长于高压布比卡因2.5 mg和25 mcg芬太尼组(155.22 + 10.68 min vs 98.69 + 7.13 min),差异有统计学意义(p<0.001)。脊髓麻醉药物以剂量依赖的方式起作用。增加剂量会增加脊髓麻醉剂作用的持续时间。唯一发现的副作用是低血压和瘙痒。结论:高压压布比卡因2.5 mg和芬太尼25 mcg脊柱麻醉可加快宫颈癌近距离放疗患者的下床时间。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Spinal Anesthesia Ambulation Time of Cervical Cancer Brachytherapy Outpatient Clinic: Comparison of 5 mg Hyperbaric Bupivacaine Fentanyl with 2,5 mg Hyperbaric Bupivacaine and 25 mcg Fentanyl
Introduction: Regional anesthetic techniques and local anesthesia have proven to be more effective than general anesthesia in the practice of ambulatory anesthesia. Spinal anesthesia is the technique of choice for ambulatory anesthesia in cervical cancer brachytherapy patients. Low-dose local anesthetics can speed up the ambulation time. This study aims to compare the ambulation time of low-dose spinal anesthesia with conventional doses. Fast ambulation time can speed up recovery time for patients, thereby reducing the patient's length of stay. Methods: This study was a double-blind, randomized controlled trial conducted in August – September 2022 at the Radiotherapy Installation of Dr. Mohammad Hoesin General Hospital (RSMH) Palembang. All cervical cancer patients undergoing brachytherapy in adults with ASA I-II physical status were included in the study sample. Samples will be randomized into two groups, namely a combination of hyperbaric bupivacaine 5 mg and fentanyl 25 mcg and a group of bupivacaine 2.5 mg and fentanyl 25 mcg. Patients with allergies, impaired motor function, spinal failure, block level not achieved, shock, apnea, respiratory depression, and experiencing pain during the procedure were excluded from the study. Results: Ambulation time in the hyperbaric bupivacaine 5 mg and 25 mcg fentanyl group was longer than the hyperbaric bupivacaine 2.5 mg and 25 mcg fentanyl (155.22 + 10.68 minutes versus 98.69 + 7.13 minutes) with a significance level of p<0.001. Spinal anesthetic drugs work in a dose-dependent manner. Increasing the dose will increase the duration of action of the spinal anesthetic. The only side effects found were hypotension and pruritus. Conclusion: Spinal anesthesia with hyperbaric bupivacaine 2.5 mg and fentanyl 25 mcg can accelerate the ambulation time of cervical cancer patients undergoing brachytherapy.
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