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地塞米松 4mg 和 8mg 对 Sodo 基督教医院成年骨科患者鞘内布比卡因围手术期镇痛效果的影响:一项前瞻性队列研究。

Effects of 4 mg and 8 mg Dexamethasone Added to Intrathecal Bupivacaine on Perioperative Analgesia Among Adult Orthopedic Patients at Sodo Christian Hospital: A Prospective Cohort Study.

机构信息

School of Anesthesia, Wolaita Soddo University, School of Anesthesia, Wolaita, Soddo, Ethiopia.

Department of Pharmacy, Wolaita Soddo University, Wolaita, Soddo, Ethiopia.

出版信息

Pain Res Manag. 2024 Oct 30;2024:8872988. doi: 10.1155/2024/8872988. eCollection 2024.

Abstract

Several adjuvant drugs have been tried to prolong spinal anesthesia block. Currently, dexamethasone appears to be effective in extending the duration of sensory block and enhancing analgesia during surgery. It is unclear, however, whether administering dexamethasone at a dose of 8 mg offers any advantages over administering it at a dose of 4 mg. To compare the effect of adding 4 and 8 mg dexamethasone to intrathecal bupivacaine on perioperative analgesia among adult orthopedic patients at Sodo Christian Hospital from June 1 to October 31, 2021. A total of 178 adult patients undergoing elective orthopedic surgery were randomly assigned to one of the two groups through a prospective cohort research design. A systematic random sampling method was used. For analysis, data were imported into EpiData v.4.6 and exported to SPSS v.25. Levene's test was used to verify homogeneity of variance, whereas the Shapiro-Wilk test was used to assess data distribution. The Mann-Whitney test and the independent sample -test were employed to compare numerical variables between study groups. Category variables were determined using the chi-square test. values were deemed statistically significant if they were less than 0.05. Between groups, the perioperative and demographic features were similar. The mean durations of sensory block (347.42 ± 91.06 versus 341.46 ± 68.84), motor block (308.36 ± 80.91 versus 310.84 ± 75.50), and overall analgesia (421.51 ± 121.62 versus 412.40 ± 107.0) minutes did not show a statistically significant difference between the groups. In addition, there was no significant difference ( > 0.05) in postoperative analgesic use, initial analgesia rescue time, or pain severity, as measured by the Numerical Rating Scale (NRS). The addition of dexamethasone did not result in any issues, nor was there a statistically significant difference in the onset time between the two groups. Dexamethasone at a dose of 4 mg extends the duration of sensory, motor, and overall analgesia in a manner similar to that of 8 mg dexamethasone with comparable durations for both the initial analgesic request and overall analgesic use.

摘要

几种辅助药物已被尝试用于延长脊髓麻醉阻滞。目前,地塞米松似乎可有效延长感觉阻滞的持续时间,并增强手术期间的镇痛效果。然而,给予 8mg 地塞米松与给予 4mg 地塞米松相比是否具有优势尚不清楚。

为了比较在 Sodo Christian 医院于 2021 年 6 月 1 日至 10 月 31 日期间对接受择期骨科手术的成年骨科患者鞘内布比卡因中添加 4mg 和 8mg 地塞米松对围手术期镇痛的效果,进行了一项前瞻性队列研究设计。采用系统随机抽样方法。为了分析,数据被输入到 EpiData v.4.6 并输出到 SPSS v.25。采用 Levene 检验验证方差同质性,而 Shapiro-Wilk 检验用于评估数据分布。采用 Mann-Whitney 检验和独立样本 t 检验比较研究组之间的数值变量。采用卡方检验确定类别变量。如果 值小于 0.05,则认为具有统计学意义。

组间围手术期和人口统计学特征相似。感觉阻滞(347.42±91.06 与 341.46±68.84)、运动阻滞(308.36±80.91 与 310.84±75.50)和整体镇痛(421.51±121.62 与 412.40±107.0)的平均持续时间在两组之间无统计学显著差异。此外,术后镇痛药物使用、初始镇痛解救时间或疼痛严重程度(NRS 评分)在两组之间也无显著差异(>0.05)。地塞米松的添加并未引起任何问题,两组之间的起始时间也无统计学显著差异。

地塞米松 4mg 剂量可延长感觉、运动和整体镇痛的持续时间,与 8mg 地塞米松相似,初始镇痛需求和整体镇痛使用的持续时间也相似。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fdf/11540886/04301a2f48af/PRM2024-8872988.001.jpg

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