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改良阿片类药物节约型麻醉对腹腔镜减重手术患者术后恢复质量的影响:一项单中心、双盲随机对照试验方案 - MOSA 研究。

Effect of modified opioid sparing anaesthesia on postoperative quality of recovery in patients undergoing laparoscopic bariatric surgery: protocol for a monocentre, double-blind randomised controlled trial - the MOSA study.

机构信息

Anesthesiology, Yan'an Hospital of Kunming City, Kunming, China.

Anesthesiology Operating Center, Yan'an Hospital of Kunming City, Kunming, China.

出版信息

BMJ Open. 2024 Jul 25;14(7):e086523. doi: 10.1136/bmjopen-2024-086523.

Abstract

INTRODUCTION

Obesity patients undergoing laparoscopic bariatric surgery (LBS) are frequently encountered perioperative adverse events related to opioids-based anaesthesia (OBA) or opioids-free anaesthesia (OFA). While modified opioid-sparing anaesthesia (MOSA) has been shown to lower the occurrence of adverse events related to OBA and OFA. This study is to assess the efficacy of MOSA in enhancing the recovery quality among individuals undergoing LBS.

METHODS AND ANALYSIS

A single-centre, prospective, double-blind, randomised controlled trial is conducted at a tertiary hospital. A total of 74 eligible participants undergoing elective LBS will be recruited and randomly allocated. Patients in the MOSA group will receive a combination of low-dose opioids, minimal dexmedetomidine, esketamine and lidocaine, while in the OBA group will receive standard general anaesthesia with opioids. Patients in both groups will receive standard perioperative care. The primary outcome is the quality of recovery-15 score assessed at 24 hours after surgery. Secondary outcomes include pain levels, anxiety and depression assessments, gastrointestinal function recovery, perioperative complication rates, opioid consumption and length of hospital stay.

ETHICS AND DISSEMINATION

Ethical approval has been provided by the Ethical Committee of Yan'an Hospital of Kunming City (approval No. 2023-240-01). Eligible patients will provide written informed consent to the investigator. The outcomes of this trial will be disseminated in a peer-reviewed scholarly journal.

TRIAL REGISTRATION NUMBER

The study protocol is registered at https://www.chictr.org.cn/ on 19 December 2023. (identifier: ChiCTR2300078806). The trial was conducted using V.1.0.

摘要

简介

接受腹腔镜减重手术(LBS)的肥胖患者经常会发生与阿片类药物为基础的麻醉(OBA)或无阿片类药物麻醉(OFA)相关的围手术期不良事件。虽然改良的阿片类药物节约型麻醉(MOSA)已被证明可以降低与 OBA 和 OFA 相关的不良事件的发生。本研究旨在评估 MOSA 对提高接受 LBS 治疗的个体恢复质量的疗效。

方法和分析

一项单中心、前瞻性、双盲、随机对照试验在一家三级医院进行。共有 74 名符合条件的择期接受 LBS 的患者被纳入并随机分组。MOSA 组患者将接受低剂量阿片类药物、最小剂量右美托咪定、依托咪酯和利多卡因的联合治疗,而 OBA 组患者将接受标准的阿片类药物全身麻醉。两组患者均接受标准的围手术期护理。主要结局是术后 24 小时时采用恢复质量-15 评分进行评估。次要结局包括疼痛程度、焦虑和抑郁评估、胃肠道功能恢复、围手术期并发症发生率、阿片类药物消耗和住院时间。

伦理和传播

昆明延安医院伦理委员会已批准(批准号:2023-240-01)。合格患者将向研究者提供书面知情同意书。本试验的结果将在同行评议的学术期刊上发表。

试验注册号

研究方案于 2023 年 12 月 19 日在 https://www.chictr.org.cn/ 注册(标识符:ChiCTR2300078806)。试验采用 V.1.0 进行。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f0b/11284863/676b21617169/bmjopen-14-7-g001.jpg

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