用于扁桃体切除术后止痛的雾化芬太尼与静脉注射芬太尼的比较分析:双盲随机对照试验。

IF 1.3 4区 医学 Q3 OTORHINOLARYNGOLOGY
Chanitda Pantabtim, Saowapark Chumpathong, Phongthara Vichitvejpaisal, Wilawan Limsettho, Peerachatra Mangmeesri
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引用次数: 0

摘要

目的:有效的扁桃体切除术后镇痛对患者的舒适和康复至关重要。芬太尼以其药效强、作用迅速和亲油性而著称,已通过多种给药途径成功用于各种手术。然而,将其雾化形式用于扁桃体切除术后疼痛的研究尚未广泛开展。本研究旨在比较雾化芬太尼和静脉注射芬太尼对扁桃体切除术后患者的镇痛效果、起效时间和并发症:在这项随机对照试验中,接受扁桃体切除术的成年患者被分配到静脉注射芬太尼组(1 mcg/kg)或雾化芬太尼组(4 mcg/kg)。在这两组中,当疼痛评分超过 3 分时就会使用芬太尼。每 5 分钟监测一次疼痛程度,直到疼痛程度降至 4 分以下。研究还记录了下次镇痛请求前的持续时间,并记录了 24 小时内的并发症(如呼吸抑制、心动过缓、胸闷、嗜睡、恶心、瘙痒、出汗和潮红)。根据预先确定的标准排除患者:在最初的 59 名患者中,有 22 名静脉注射组患者和 27 名雾化吸入组患者在适用排除标准后符合分析条件。雾化吸入组距下一次镇痛请求的时间明显较长,中位数为 683.5 分钟(四分位间范围为 260-1440),而静脉注射组为 326.7 分钟(145.0-504.7)(P = .009)。两组患者达到疼痛评分小于 4 分的时间和副作用发生率没有显著差异:结论:在扁桃体切除术后疼痛治疗中,雾化芬太尼比静脉注射芬太尼的镇痛时间更长,起效时间和副作用情况相似。这些发现强调了雾化芬太尼作为扁桃体切除术后患者止痛的有效替代品的潜力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparative Analysis of Nebulized Versus Intravenous Fentanyl for Pain Control After Tonsillectomy: A Double-Blind, Randomized, Controlled Trial.

Objectives: Effective posttonsillectomy analgesia is crucial for patient comfort and recovery. Fentanyl, notable for its potency, rapid action, and lipophilicity, has been successfully used in various procedures through multiple administration routes. However, the use of its nebulized form for posttonsillectomy pain has not been extensively explored. This study sought to compare the analgesic efficacy, onset time, and complications between nebulized and intravenous fentanyl in posttonsillectomy patients.

Methods and methods: In this randomized controlled trial, adult patients who underwent tonsillectomy were assigned to either an intravenous fentanyl group (1 mcg/kg) or a nebulized fentanyl group (4 mcg/kg). In both groups, fentanyl was administered when pain scores exceeded three. Pain levels were monitored every 5 minutes until they fell below four. The study also recorded the duration until the next analgesia request and noted complications (such as respiratory depression, bradycardia, chest tightness, drowsiness, nausea, pruritus, sweating, and flushing) within 24 hours. Patient exclusions were based on predetermined criteria.

Results: From an initial cohort of 59 patients, 22 in the intravenous group and 27 in the nebulizer group were eligible for analysis after applying the exclusion criteria. The nebulizer group exhibited a significantly prolonged period before the next analgesia request, with a median of 683.5 minutes (interquartile range 260-1440), in contrast to the 326.7 minutes (145.0-504.7) observed in the intravenous group (P = .009). The time to achieve a pain score less than 4 and the incidence of side effects did not differ significantly between the groups.

Conclusion: Nebulized fentanyl provided a longer duration of analgesia than intravenous fentanyl in posttonsillectomy pain management, with similar onset times and side effect profiles. These findings underscore the potential of nebulized fentanyl as an effective alternative for pain control in posttonsillectomy patients.

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来源期刊
CiteScore
3.10
自引率
7.10%
发文量
171
审稿时长
4-8 weeks
期刊介绍: The Annals of Otology, Rhinology & Laryngology publishes original manuscripts of clinical and research importance in otolaryngology–head and neck medicine and surgery, otology, neurotology, bronchoesophagology, laryngology, rhinology, head and neck oncology and surgery, plastic and reconstructive surgery, pediatric otolaryngology, audiology, and speech pathology. In-depth studies (supplements), papers of historical interest, and reviews of computer software and applications in otolaryngology are also published, as well as imaging, pathology, and clinicopathology studies, book reviews, and letters to the editor. AOR is the official journal of the American Broncho-Esophagological Association.
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