静脉注射地塞米松对下腹部手术中布比卡因椎管内麻醉持续时间的影响：随机对照试验。

Effect of intravenous dexamethasone on the duration of hyperbaric bupivacaine spinal anesthesia in lower abdominal surgery, Randomized controlled trial.

机构信息

Anesthesia and Intensive Care Department, Faculty of Medicine, Assiut University, Assiut, Egypt.

出版信息

BMC Anesthesiol. 2023 Sep 22;23(1):323. doi: 10.1186/s12871-023-02282-y.

DOI:10.1186/s12871-023-02282-y

PMID:37736711

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10515039/

Abstract

BACKGROUND

The purpose of this study was to investigate the effect of intravenous (IV) dexamethasone on the duration of hyperbaric bupivacaine spinal anesthesia.

METHODS

Two hundred patients between the ages of 18 and 60, of both sexes with ASA I- II classification scheduled for lower abdominal surgery under spinal anesthesia using hyperbaric bupivacaine 0.5% were randomly divided into two groups: the dexamethasone group (Dexa group) and the control group, with 100 patients in each group. Before the administration of spinal anesthesia, the Dexa group received an intravenous infusion of 8 mg dexamethasone in 500 mL normal saline, while the control group received 500 mL normal saline only. The primary outcome of this study was to assess the effect of IV dexamethasone on the regression of hyperbaric bupivacaine spinal anesthesia. Secondary outcome measures included the total duration of sensory and motor blocks, VAS score, time of first analgesic request, total analgesic consumption within the first 24 h, and the occurrence of any side effects.

RESULTS

The Dexa group had significantly delayed onset of 2 dermatomes regression (P < 0.001) compared to the control group. Additionally, the Dexa group had significantly longer duration of both sensory block (P = 0.01) and motor block (P < 0.001). The Dexa group had significantly longer duration until the first postoperative analgesic request (P < 0.001) and a lower incidence of side effects compared to the control group.

CONCLUSION

Although the intravenous administration of dexamethasone had a limited effect on the duration of hyperbaric bupivacaine spinal anesthesia, it improved postoperative VAS scores compared to the control group and decreased overall postoperative analgesic consumption. Therefore, it can be considered a valuable addition to postoperative multimodal analgesia strategies, aiming to minimize total analgesic consumption.

CLINICAL TRIAL REGISTRATION

ID: NCT04778189 (2/3/2021).

摘要

背景

本研究旨在探讨静脉注射地塞米松对布比卡因椎管内麻醉持续时间的影响。

方法

选择 200 例年龄在 18 至 60 岁之间、ASA I-II 分级、拟行下腹部手术的患者，在蛛网膜下腔注射 0.5%重比重布比卡因，随机分为两组：地塞米松组（Dexa 组）和对照组，每组 100 例。在给予蛛网膜下腔麻醉前，Dexa 组静脉输注 8mg 地塞米松加入 500ml 生理盐水，对照组给予 500ml 生理盐水。本研究的主要结局是评估静脉注射地塞米松对布比卡因椎管内麻醉消退的影响。次要结局包括感觉和运动阻滞的总持续时间、VAS 评分、首次镇痛要求时间、24 小时内总镇痛消耗以及任何不良反应的发生。