神经周围地塞米松比神经周围右美托咪定更有效地延长腘窝坐骨和隐神经阻滞:一项单中心、前瞻性、双盲、随机对照试验

IF 1.5 Q3 ANESTHESIOLOGY
Local and Regional Anesthesia Pub Date : 2025-05-07 eCollection Date: 2025-01-01 DOI:10.2147/LRA.S515510
Guiyu Lei, Lili Wu, Yue Yin, Shu Zhang, Guyan Wang
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引用次数: 0

摘要

目的:本研究旨在评估和比较围神经地塞米松(DEX)和右美托咪定(DEM)作为辅助治疗腘窝坐骨和隐神经阻滞的有效性,重点关注足部和踝关节大手术后的镇痛持续时间和副作用。患者与方法:90例全麻下行足踝大手术的患者,均行腘窝坐骨神经和隐神经阻滞,随机分为3组:(1)对照组给予0.375%罗哌卡因;(2) DEX组给予0.375%罗哌卡因联合神经周地塞米松10 mg;(3) DEM组给予0.375%罗哌卡因联合0.75 μg/kg右美托咪定。测量的主要结果是镇痛持续时间,定义为从给予神经阻滞到手术区域出现第一次疼痛感觉的时间。次要结局包括术后48小时内阿片类药物的消耗以及低血压和心动过缓等副作用的发生率。(临床试验注册号:ChiCTR2100048127)。结果:与DEM组(24.1(1.3)小时)和对照组(17.5(3.5)小时相比,右美托咪定组(28.0(3.3)小时)至第一次感觉疼痛的时间显著延长。结论:10 mg地塞米松和0.75µg/kg右美托咪定均能有效延长腘窝坐骨和隐神经阻滞的足踝大手术患者的镇痛时间。然而,与右美托咪定(0.75µg/kg)相比,地塞米松(10 mg)提供的镇痛持续时间明显更长。试验注册:Chictr.org.cn标识符:ChiCTR2100048127。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Perineural Dexamethasone is More Efficient Than Perineural Dexmedetomidine in Prolonging Popliteal Sciatic and Saphenous Nerve Blocks: A Single-Center, Prospective, Double-Blinded, Randomized Controlled Trial.

Purpose: This study aims to assess and compare the effectiveness of perineural dexamethasone (DEX) and perineural dexmedetomidine (DEM) as adjuvant in popliteal sciatic and saphenous nerve blocks, focusing on the duration of analgesia and side effects following major foot and ankle surgeries.

Patients and methods: Ninety patients scheduled for major foot and ankle surgeries under general anesthesia, who received popliteal sciatic and saphenous nerve blocks, were randomly assigned to one of three groups: (1) control group receiving 0.375% ropivacaine; (2) DEX group receiving 0.375% ropivacaine combined with 10 mg perineural dexamethasone; (3) DEM group receiving 0.375% ropivacaine combined with 0.75 μg/kg perineural dexmedetomidine. The primary outcome measured was the duration of analgesia, defined as the time from the administration of the nerve block to the onset of the first pain sensation in the surgical area. Secondary outcomes included opioid consumption within the first 48 hours post-surgery and the incidence of side effects such as hypotension and bradycardia. (Clinical trial registration number: ChiCTR2100048127).

Results: The time until the first perception of pain was significantly extended in the DEX group (28.0 (3.3) hours) compared to the DEM group (24.1 (1.3) hours) and the control group (17.5 (3.5) hours, P<0.001). Additionally, opioid consumption within the first 24 hours was markedly reduced in both the DEX and DEM groups compared to the control group (P<0.001). However, opioid usage between 0 to 48 hours post-surgery showed no significant differences among the three groups. The DEM group experienced a higher incidence of hypotension and bradycardia compared to both the DEX and control group (P<0.001).

Conclusion: Both 10 mg dexamethasone and 0.75 µg/kg dexmedetomidine effectively prolonged analgesia in patients undergoing major foot and ankle surgery with a popliteal sciatic and saphenous nerve block. However, dexamethasone (10 mg) provided a significantly longer duration of analgesia compared to dexmedetomidine (0.75 µg/kg).

Trial registration: Chictr.org.cn identifier: ChiCTR2100048127.

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CiteScore
6.30
自引率
0.00%
发文量
12
审稿时长
16 weeks
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