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局部镇痛药(利多卡因)和阿片类镇痛药(舒芬太尼)对中枢介导性腹痛综合征患者的短期疗效评估:一项随机对照试验。

Evaluation of the short-term efficacy of local analgesic (lidocaine) and opioid analgesic (sufentanil) on patients with centrally mediated abdominal pain syndrome: a randomized controlled trial.

作者信息

Yang Hang, Chen Honglin, Hu Bing

机构信息

Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China.

404 Hospital, Mianyang City, China.

出版信息

Therap Adv Gastroenterol. 2021 Jun 24;14:17562848211021783. doi: 10.1177/17562848211021783. eCollection 2021.

Abstract

BACKGROUND

Centrally mediated abdominal pain syndrome (CAPS) is characterized by continuous or frequently recurring abdominal pain and can result in functional loss across several life domains. The efficacy of the present management methods has not been established yet. We performed a prospective randomized controlled trial to explore the short-term efficacy of local analgesic (lidocaine) and opioid analgesic (sufentanil) in patients with CAPS.

METHODS

We consecutively enrolled 130 patients who met the Rome IV CAPS criteria and divided them into the sufentanil + lidocaine (S + L) group and sufentanil (S) group. Patients completed the pain rating scales, including the numeric rating scale (NRS) and verbal rating scale (VRS), 60 min before colonoscopy. All the patients were initially administered sufentanil. In the S + L group, we sprayed a 5 ml solution of lidocaine on the surface of ascending, transverse, descending, and sigmoid colon during colonoscope withdrawal, while 5 ml saline was sprayed in the S group. Follow up was performed 1 day, 3 days, 1 week, 2 weeks, 1 month, and 3 months after colonoscopy, to complete the pain scaling.

RESULTS

A comparison of the NRS and VRS showed that there were no significant differences between the S + L and S groups and within each group ( > 0.05).

CONCLUSIONS

Local analgesic lidocaine and opioid analgesic sufentanil showed negative efficacy during short-term observation. The opioid receptor blocker sufentanil did not worsen symptoms in patients with CAPS after colonoscopy under general anesthesia in the short term.[chictr.org.cn, Chinese Clinical Trial Identifier, ChiCTR-IOR-16008187].

摘要

背景

中枢介导的腹痛综合征(CAPS)的特征是持续性或频繁复发的腹痛,并可导致多个生活领域的功能丧失。目前的治疗方法的疗效尚未确定。我们进行了一项前瞻性随机对照试验,以探讨局部镇痛药(利多卡因)和阿片类镇痛药(舒芬太尼)对CAPS患者的短期疗效。

方法

我们连续纳入了130例符合罗马IV型CAPS标准的患者,并将他们分为舒芬太尼+利多卡因(S+L)组和舒芬太尼(S)组。患者在结肠镜检查前60分钟完成疼痛评分量表,包括数字评分量表(NRS)和语言评分量表(VRS)。所有患者均首先给予舒芬太尼。在S+L组中,在结肠镜退出时,我们在升结肠、横结肠、降结肠和乙状结肠表面喷洒5ml利多卡因溶液,而在S组中喷洒5ml生理盐水。在结肠镜检查后1天、3天、1周、2周、1个月和3个月进行随访,以完成疼痛评分。

结果

NRS和VRS的比较表明,S+L组和S组之间以及每组内均无显著差异(>0.05)。

结论

局部镇痛药利多卡因和阿片类镇痛药舒芬太尼在短期观察中显示出无效。在全身麻醉下结肠镜检查后,阿片受体阻滞剂舒芬太尼在短期内并未使CAPS患者的症状恶化。[中国临床试验注册中心,中国临床试验标识符,ChiCTR-IOR-16008187]

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5ed7/8237217/77811876eef0/10.1177_17562848211021783-fig1.jpg

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