右旋美托嘧啶顾小萍课件.ppt

* * MEASUREMENTS AND MAIN RESULTS: Measurements included patient demographics, American Society of Anesthesiologists Physical Status Classification System, levels of spinal fusion, length of hospital stay, complications, numeric pain scores, opioid requirement, elastomeric pain pump use, length of time until ambulation, adverse effects, and naloxone use. Data were collected through the first 72 hours of the perioperative period. One hundred six patients received opioids via patient-controlled analgesia therapy with dexmedetomidine and 57 received opioids via patient-controlled analgesia alone. Within the groups, there were 46 patients who received local anesthetic infusions via elastomeric pumps in the patient-controlled analgesia with dexmedetomidine group and 16 patients had pumps in the patient-controlled analgesia-alone group. There was no overall difference in postoperative use of morphine (or equivalents) between the two groups. However, the use of elastomeric pain pumps demonstrated a statistically significant decrease in mean overall opioid consumption (42.6 mg vs 63.1 mg, p 0.001). * * CONCLUSIONS: There was no difference in opioid use related to dexmedetomidine on any postoperative day. The only variable showing a significant opioid sparing effect was the use of local anesthetic infusions via elastomeric pumps. Using continuous local anesthetic infusions instead of dexmedetomidine could eliminate the need for ICU admission, require shorter hospital stays, and reduce costs while still providing safe and effective pain control. * * Comparison of patient-controlled analgesia with and without dexmedetomidine following spine surgery in children. Sadhasivam S1, Boat A, Mahmoud M. J Clin Anesth. 2009 Nov;21(7):493-501 * * DESIGN: Retrospective comparison. SETTING: University-affiliated childrens hospital. MEASUREMENTS: The medical charts of 131 children with idiopathic scoliosis (IS) and NMS who had major spine surgery were reviewed. Out of