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比较术后疼痛缓解情况:酮咯酸与鼻钙素喷雾剂联用与利多卡因与鼻钙素喷雾剂联用在腹部手术患者中的效果

Comparing postoperative pain relief: ketorolac and Nasocalcin spray versus lidocaine and Nasocalcin spray in abdominal surgery patients.

作者信息

Saadat Fakhr Masoud, Qasemi Mahdiya, Rezvanfar Kiana, Hosseini Reza Shah, Amini Zahra, Amiri Koosha, Zhaleh Mahan, Tarkashvand Taraneh, Narimani Zamanabadi Mahnaz

机构信息

Faculty of Medicine, Tehran Medical Sciences Branch, Islamic Azad University.

Istanbul Medipol University, Faculty of Medicine, Medical Student, Istanbul, Turkey.

出版信息

Ann Med Surg (Lond). 2024 Aug 30;86(10):5823-5829. doi: 10.1097/MS9.0000000000002285. eCollection 2024 Oct.

Abstract

OBJECTIVES

Postoperative pain management is critical for patient recovery after abdominal surgery. This study compared intravenous lidocaine and ketorolac for reducing postoperative pain and opioid use, along with Nasocalcin nasal spray.

METHODS

In this randomized controlled trial, 58 abdominal surgery patients were allocated to receive either intravenous lidocaine plus Nasocalcin spray (=29) or intravenous ketorolac plus Nasocalcin spray (=29) before surgery. Pain intensity (visual analog scale) and postoperative opioid consumption were assessed at 1, 6, 12, and 24 h after surgery.

RESULTS

Patients receiving ketorolac plus Nasocalcin spray reported significantly lower pain scores at all time points compared to lidocaine plus Nasocalcin (<0.001). Average 24-h pain scores were 4.5 with ketorolac versus 5.1 with lidocaine. Mean opioid consumption was also lower in the ketorolac group (31.9 mg) versus the lidocaine group (43.9 mg, <0.001).

CONCLUSION

Preoperative ketorolac plus Nasocalcin nasal spray resulted in superior pain relief and less opioid use compared to lidocaine plus Nasocalcin after abdominal surgery. Ketorolac may be a more effective analgesic option, while Nasocalcin spray is a safe adjunct. These findings can inform clinical practice for optimizing postoperative analgesia.

摘要

目的

术后疼痛管理对腹部手术后患者的恢复至关重要。本研究比较了静脉注射利多卡因和酮咯酸在减轻术后疼痛及减少阿片类药物使用方面的效果,并同时使用了鼻用钙尔奇鼻腔喷雾剂。

方法

在这项随机对照试验中,58例腹部手术患者被分配在手术前接受静脉注射利多卡因加鼻用钙尔奇喷雾剂(n = 29)或静脉注射酮咯酸加鼻用钙尔奇喷雾剂(n = 29)。在术后1、6、12和24小时评估疼痛强度(视觉模拟评分)和术后阿片类药物消耗量。

结果

与利多卡因加鼻用钙尔奇喷雾剂组相比,接受酮咯酸加鼻用钙尔奇喷雾剂的患者在所有时间点的疼痛评分均显著更低(P<0.001)。酮咯酸组24小时平均疼痛评分为4.5,而利多卡因组为5.1。酮咯酸组的平均阿片类药物消耗量也低于利多卡因组(31.9 mg对43.9 mg,P<0.001)。

结论

与腹部手术后使用利多卡因加鼻用钙尔奇喷雾剂相比,术前使用酮咯酸加鼻用钙尔奇鼻腔喷雾剂能带来更好的疼痛缓解效果且减少阿片类药物的使用。酮咯酸可能是一种更有效的镇痛选择,而鼻用钙尔奇喷雾剂是一种安全的辅助药物。这些研究结果可为优化术后镇痛的临床实践提供参考。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a008/11444628/1ebc60a8ab7f/ms9-86-5823-g001.jpg

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