右美托咪定对视频胆囊切除术中疼痛控制和心血管功能的免疫治疗特性:一项随机、双臂、双盲、安慰剂对照试验。

IF 1.2 4区 医学 Q3 SURGERY
Surgical Innovation Pub Date : 2024-04-01 Epub Date: 2024-02-21 DOI:10.1177/15533506241234591
Gustavo Nascimento Silva, Virna Guedes Brandão, Marcelo Vaz Perez, Sandoval Lage Sobrinho, João Gabriel de Cerqueira Campos Villardi, Priscilla Mendonça do Sacramento, Luiz Claudio Pereira Ribeiro, Rossano Kepler Alvim Fiorelli
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引用次数: 0

摘要

背景:腹腔镜手术是外科领域最具创新性的外科技术之一。右美托咪定与全身麻醉相结合,通过改变神经炎症反射促进创伤反应控制,在术后提供更好的临床疗效,并减少过量使用药物导致成瘾的风险。本试验旨在评估右美托咪定对机体功能的潜在药物治疗作用,目标是中型手术模型中的神经炎症、围术期疼痛控制和血压测量:52名患者被随机分为两组:方法:52 名患者随机分为两组:七氟烷和右美托咪定-A 组(右美托咪定输注[1 μg/kg 负荷,之后.2-.5 μg/kg/h]) 与七氟烷和生理盐水 .9%-B 组。主要结果是炎症和内分泌介质剂量分析。最后,我们将疼痛和阿片类药物的使用以及血液动力学数值作为次要结果进行评估:结果:在右美托咪定 A 组中,术后 4-6 小时内白细胞介素 6 减少。在术后 24 小时测量 IL-10 的值时发现,IL-10 有所下降,且有统计学意义。此外,收缩压和舒张压以及心率也有所降低,麻醉恢复室的疼痛发生率和术后第一小时的阿片类药物用量也有所降低(P < .0001):结论:右美托咪定具有抗炎活性、交感溶解作用和镇痛效果,且对心血管安全。它加强了高选择性α2-肾上腺素能激动剂在麻醉干预中的治疗作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Immunotherapeutic Properties of Dexmedetomidine on Pain Management and Cardiovascular Function in Videolaparoscopic Cholecystectomies: A Randomized, Two-Arm, Double-Blinded, Placebo-Controlled Trial.

Background: Laparoscopy represented one of the most innovative surgical techniques approached in the surgery field. Dexmedetomidine association with general anesthesia promotes the response control to trauma by altering the neuroinflammatory reflex, provides better clinical outcomes in the postoperative period and reduces the excessive use of drugs with risk for addiction. This trial aims to evaluate the potential drug treatment of dexmedetomidine on organic function, with the targets in neuroinflammation, perioperative pain control and blood pressure measurements in a medium-sized surgical model.

Methods: Fifty-two patients were randomized in two groups: Sevoflurane and Dexmedetomidine - A (dexmedetomidine infusion [1 μg/kg loading, .2-.5 μg/kg/h thereafter]) vs Sevoflurane and Saline .9% - B. Three blood samples were collected at three times: before surgery, 4 to 6 hours after surgery and 24 hours postoperatively. The primary outcome was inflammatory and endocrine mediators dosage analisys. Finally, we evaluated pain and opioid use as secondary outcomes, also the hemodynamic values.

Results: In Dexmedetomidine group A, a reduction of Interleukin 6 was found during 4-6 hours after surgery. A reduction of IL-10 was noted in the measurement of its values 24 hours after the procedure, with statistical significance. Also, systolic and diastolic blood pressure, as well heart rate were attenuated, and there was a lower incidence of pain and opioid consumption in the first postoperative hour (P < .0001) in the anesthetic recovery room.

Conclusions: Dexmedetomidine provided anti-inflammatory activity, sympatholytic effect and analgesia with cardiovascular safety. It reinforces the therapeutic nature of highly selective α2-adrenergic agonists when combined within anesthetic interventions.

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来源期刊
Surgical Innovation
Surgical Innovation 医学-外科
CiteScore
2.90
自引率
0.00%
发文量
72
审稿时长
6-12 weeks
期刊介绍: Surgical Innovation (SRI) is a peer-reviewed bi-monthly journal focusing on minimally invasive surgical techniques, new instruments such as laparoscopes and endoscopes, and new technologies. SRI prepares surgeons to think and work in "the operating room of the future" through learning new techniques, understanding and adapting to new technologies, maintaining surgical competencies, and applying surgical outcomes data to their practices. This journal is a member of the Committee on Publication Ethics (COPE).
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