腹横肌平面阻滞中联合使用地塞米松和右美托咪定的双重辅助治疗可减少结直肠手术后阿片类药物的使用。
Dual adjunct therapy with dexamethasone and dexmedetomidine in transversus abdominis plane blocks reduces postoperative opioid use in colorectal surgery.
机构信息
University of Tennessee College of Medicine Chattanooga, Department of Surgery, Chattanooga, TN, USA.
University of Tennessee College of Medicine Chattanooga, Department of Anesthesiology, Chattanooga, TN, USA.
出版信息
Am J Surg. 2021 Jul;222(1):198-202. doi: 10.1016/j.amjsurg.2020.09.027. Epub 2020 Sep 26.
BACKGROUND
The objective of this study is to determine if the addition of dexmedetomidine to dexamethasone in transversus abdominis plane (TAP) blocks lowers postoperative opioid use following colorectal surgery.
METHODS
Retrospective review of patients undergoing minimally invasive colorectal surgery and perioperative TAP block with either 1) local anesthetic and dexamethasone or 2) local anesthetic, dexamethasone, and dexmedetomidine. Post-operative opioid use was converted to morphine milligram equivalents (MME).
RESULTS
55 patients were identified: 38 (69%) receiving dexamethasone only and 17 (31%) receiving dexamethasone and dexmedetomidine. The dexamethasone and dexmedetomidine group had significantly lower median MME use at 12-h (2 vs. 13 mg), 24-h (4 vs. 28 mg), 36-h (8 vs. 38 mg), and 48-h (17 vs. 53 mg) (all p < 0.05). There was no difference at 72-h.
CONCLUSION
Perioperative TAP blocks with dexamethasone and dexmedetomidine following colorectal surgery results in significantly less postoperative opioid use up to 48 h after surgery.
背景
本研究旨在确定在腹横肌平面（TAP）阻滞中加入右美托咪定是否会降低结直肠手术后阿片类药物的使用。
方法
回顾性分析接受微创结直肠手术和围手术期 TAP 阻滞的患者，使用 1）局部麻醉和地塞米松或 2）局部麻醉、地塞米松和右美托咪定。术后阿片类药物的使用转换为吗啡毫克当量（MME）。
结果
共纳入 55 例患者：38 例（69%）仅接受地塞米松，17 例（31%）接受地塞米松和右美托咪定。地塞米松和右美托咪定组在 12 小时（2 对 13mg）、24 小时（4 对 28mg）、36 小时（8 对 38mg）和 48 小时（17 对 53mg）的中位数 MME 使用量显著降低（均 p<0.05）。72 小时时无差异。
结论
结直肠手术后在 TAP 阻滞中加入地塞米松和右美托咪定可显著减少术后 48 小时内的阿片类药物使用。
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