Li Cheng-Wei, Liaw Wen-Jinn, Wang Yu-Hsun, Lin Hsiu-Ying
Department of Anesthesiology, Chung Shan Medical University Hospital, Taichung, Taiwan.
School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
Asian J Anesthesiol. 2023 Dec 1;61(4):183-193. doi: 10.6859/aja.202312_61(4).0005.
Inadequate postoperative analgesia may cause postoperative complications, such as pulmonary complications. This study evaluated the analgesic effectiveness of a single preoperative injection of dinalbuphine sebacate (DS) in patients undergoing video-assisted thoracoscopic wedge resection and assessed whether it can reduce the incidence of postoperative pulmonary complications (PPCs).
In this study, the data of 757 patients who underwent VATS wedge resection at a medical center were retrospectively reviewed. The patients were divided into the DS group and the conventional analgesia (CA) group. The following parameters were analyzed: analgesic consumption during hospitalization, the incidence of PPCs, and the postoperative use of oxygen therapy.
Compared with the CA group, the DS group had lower nalbuphine, tramadol, parecoxib, acetaminophen, diclofenac, and utraphen consumption during the postoperative period; higher morphine and ketorolac consumption; and comparable fentanyl consumption. Nonetheless, the frequency of requesting pain relief was significantly lower in the DS group. No significant between-group differences were noted in the incidence of PPCs. However, the DS group had fewer requirements for oxygen therapy in the ward, early removal of chest tubes, and shorter length of hospital stay.
A single preoperative injection of DS reduced the frequency of salvage analgesic administration and total consumption of certain postoperative analgesics, suggesting the effective pain relief of DS, and it did not increase the incidence of PPCs. Additionally, it reduced the need for postoperative oxygen therapy, which may suggest a better prognosis and smoother postoperative pulmonary recovery for patients.
术后镇痛不足可能导致术后并发症,如肺部并发症。本研究评估了术前单次注射癸二酸二丁啡诺(DS)对接受电视辅助胸腔镜楔形切除术患者的镇痛效果,并评估其是否能降低术后肺部并发症(PPCs)的发生率。
本研究回顾性分析了某医疗中心757例行电视辅助胸腔镜楔形切除术患者的数据。患者分为DS组和传统镇痛(CA)组。分析以下参数:住院期间的镇痛药物消耗量、PPCs的发生率以及术后氧疗的使用情况。
与CA组相比,DS组术后纳布啡、曲马多、帕瑞昔布、对乙酰氨基酚、双氯芬酸和优洛芬的消耗量较低;吗啡和酮咯酸的消耗量较高;芬太尼消耗量相当。尽管如此,DS组的疼痛缓解请求频率显著较低。两组在PPCs发生率方面未观察到显著差异。然而,DS组在病房的氧疗需求较少、胸腔引流管拔除较早且住院时间较短。
术前单次注射DS降低了补救性镇痛给药的频率和某些术后镇痛药的总消耗量,表明DS具有有效的镇痛作用,且未增加PPCs的发生率。此外,它减少了术后氧疗的需求,这可能表明患者预后更好且术后肺部恢复更顺利。