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维生素 C 对腹腔镜胆囊切除术后吗啡使用的影响:一项随机对照试验。

Effect of vitamin C on morphine use after laparoscopic cholecystectomy: a randomized controlled trial.

机构信息

Department of Anesthesiology, American University of Beirut Medical Center, Beirut, Lebanon.

出版信息

Can J Anaesth. 2012 Jun;59(6):538-43. doi: 10.1007/s12630-012-9692-x. Epub 2012 Mar 9.

Abstract

PURPOSE

We designed a randomized double-blind placebo-controlled trial to assess the role of a single prophylactic dose of vitamin C (2 g) po in reducing the consumption of opioids postoperatively in patients undergoing laparoscopic cholecystectomy.

METHODS

Eighty adult patients were allocated to receive 2 g vitamin C po or placebo approximately one hour prior to induction of anesthesia. Following laparoscopic cholecystectomy, patients received morphine patient-controlled analgesia for 24 hr. The following data were assessed postoperatively in the postanesthesia care unit at two, four, six, 12, and 24 hr: morphine consumption, verbal numerical rating scale scores for incisional pain and nausea/vomiting, and pruritus and sedation scores. The primary outcome measure was 24-hr morphine consumption. Patient satisfaction was assessed before hospital discharge.

RESULTS

Morphine consumption was significantly lower in the vitamin C group vs the placebo group [16.2 (10.7) and 22.8 (13.8) mg, respectively; difference = 6.6 mg; 95% confidence interval, 1.1 to 12.1 mg; P = 0.02]. There was no difference in pain scores or side effects between the two groups. Satisfaction scores were similar in both groups.

CONCLUSION

Our study showed that supplementation with vitamin C (2 g) po decreased morphine consumption in the postoperative period in patients undergoing laparoscopic cholecystectomy.

摘要

目的

我们设计了一项随机、双盲、安慰剂对照试验,旨在评估在接受腹腔镜胆囊切除术的患者中,术前单次给予维生素 C(2 克,口服)预防剂量对减少术后阿片类药物消耗的作用。

方法

80 名成年患者被分配接受 2 克维生素 C 口服或安慰剂,大约在麻醉诱导前 1 小时。在完成腹腔镜胆囊切除术后,患者接受吗啡患者自控镇痛 24 小时。术后在麻醉后恢复室评估以下数据:术后 2、4、6、12 和 24 小时吗啡消耗、切口疼痛和恶心/呕吐的数字评分量表评分、瘙痒和镇静评分。主要结局指标是 24 小时吗啡消耗量。在出院前评估患者满意度。

结果

与安慰剂组相比,维生素 C 组的吗啡消耗量明显降低[分别为 16.2(10.7)和 22.8(13.8)mg;差值=6.6mg;95%置信区间,1.1 至 12.1mg;P=0.02]。两组间疼痛评分或副作用无差异。两组患者满意度评分相似。

结论

我们的研究表明,口服补充维生素 C(2 克)可减少腹腔镜胆囊切除术后患者的吗啡消耗。

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