Lam K Ky, Mui W Lm
Hong Kong Bariatric and Metabolic Institute and Evangel Hospital Weight Management Centre, Room 610, Champion Building, 301-309 Nathan Road, Jordan, Hong Kong.
Hong Kong Med J. 2016 Oct;22(5):428-34. doi: 10.12809/hkmj154769. Epub 2016 Jul 15.
To investigate whether a new anaesthesia protocol can reduce opioid use in obese patients following laparoscopic sleeve gastrectomy.
This prospective observational case series was conducted in a private hospital in Hong Kong that has been accredited as a Centre of Excellence for Bariatric Surgery. Thirty consecutive patients scheduled for laparoscopic sleeve gastrectomy from 1 January 2015 to 31 March 2015 were reviewed.
Of the 30 patients, 14 (46.7%) did not require any opioids for rescue analgesia during the entire postoperative period; six (20.0%) required rescue opioids only in the post-anaesthetic care unit, but not in the surgical ward. The mean postoperative total opioid requirement per patient was 32 mg of pethidine.
With combination of multimodal analgesia with local anaesthetic infiltration, it is possible to avoid giving potent long-acting opioids in anaesthesia for bariatric surgery.
探讨一种新的麻醉方案是否能减少肥胖患者腹腔镜袖状胃切除术后的阿片类药物使用量。
本前瞻性观察性病例系列研究在香港一家被认可为肥胖症手术卓越中心的私立医院进行。对2015年1月1日至2015年3月31日期间连续30例计划接受腹腔镜袖状胃切除术的患者进行了回顾。
30例患者中,14例(46.7%)在整个术后期间无需任何阿片类药物进行补救镇痛;6例(20.0%)仅在麻醉后护理单元需要补救性阿片类药物,而在外科病房不需要。每位患者术后阿片类药物的平均总需求量为32毫克哌替啶。
通过多模式镇痛与局部麻醉浸润相结合,在肥胖症手术麻醉中有可能避免使用强效长效阿片类药物。