Dahaba Ashraf A, Mueller Gabriele, Mattiassich Georg, Rumpold-Seitlinger Gudrun, Bornemann Helmar, Rehak Peter H, Linck Guillermo, Mischinger Hans-Joerg, Metzler Helfried
Department of Anaesthesiology and Intensive Care Medicine, Medical University of Graz, Auenbruggerplatz 29, A-8036 Graz, Austria.
Eur J Pain. 2009 Sep;13(8):861-4. doi: 10.1016/j.ejpain.2008.10.006. Epub 2008 Dec 11.
Octreotide acetate is an 8-amino-acids synthetic octapeptide analogue of somatostatin with much-enhanced duration of action and lower incidence of side effects. We assessed the utility of using intravenous octreotide as an adjuvant to opioid analgesia that might exert a post-operative opioid-sparing effect.
Forty-four patients were randomly allocated, to receive either a placebo or intraoperative octreotide 0.33 microg kg(-1)h(-1) intravenous infusion that was maintained in the post-operative period. Patients received for post-operative analgesia an intravenous piritramide patient controlled analgesia (PCA), set to deliver a piritramide 0.02 mgkg(-1) dose.
Two-way ANOVA revealed significantly fewer (P=0.0003) mean+/-SD weighted piritramide dose requirements in the octreotide group (19.5+/-6.3 microg kg(-1)h(-1)) than in the control group (35.7+/-8.2 microg kg(-1)h(-1)). Dunnett's two-sided multiple-comparison post hoc test revealed a significant difference between the two groups during the first 22 post-operative hours, following which there were no differences between the two groups. There were no significant differences over time in the mean arterial pressure (P=0.722), heart rate (P=0.579) and respiratory rate (P=0.823) between the octreotide group (80+/-10mm Hg, 74+/-12, 14+/-2) and the control group (82+/-9 mm Hg, 76+/-11, 15+/-3), respectively.
We demonstrated that perioperative octreotide intravenous infusion could be an adjuvant to opioid analgesia as it exerted a piritramide opioid-sparing effect. We encountered more systemic side effects such as nausea, abdominal discomfort, and diarrhea in the octreotide group than in the control group. Our findings could be beneficial to patients who cannot tolerate the adverse effects of opioids.
醋酸奥曲肽是一种8氨基酸的合成八肽，是生长抑素的类似物，其作用持续时间大大延长，副作用发生率较低。我们评估了静脉注射奥曲肽作为阿片类药物镇痛辅助剂的效用，其可能产生术后阿片类药物节省效应。
44例患者被随机分配，分别接受安慰剂或术中静脉输注奥曲肽0.33微克/千克（-1）小时（-1），术后持续维持。患者术后镇痛采用静脉注射匹利卡明患者自控镇痛（PCA），设定匹利卡明剂量为0.02毫克/千克。
双向方差分析显示，奥曲肽组（19.5±6.3微克/千克（-1）小时（-1））的平均±标准差加权匹利卡明剂量需求显著低于对照组（35.7±8.2微克/千克（-1）小时（-1））（P = 0.0003）。Dunnett双侧多重比较事后检验显示，术后前22小时两组之间存在显著差异，之后两组之间无差异。奥曲肽组（80±10毫米汞柱，74±12，14±2）和对照组（82±9毫米汞柱，76±11，15±3）的平均动脉压（P = 0.722）、心率（P = 0.579）和呼吸频率（P = 0.823）随时间无显著差异。
我们证明围手术期静脉输注奥曲肽可作为阿片类药物镇痛的辅助剂，因为它具有匹利卡明阿片类药物节省效应。与对照组相比，我们在奥曲肽组中遇到了更多的全身副作用，如恶心、腹部不适和腹泻。我们的发现可能对无法耐受阿片类药物不良反应的患者有益。
