Combination of dexamethasone and dexmedetomidine as adjuvants of transversus abdominis plane block for postoperative analgesia in gastric cancer patients: A double-blinded randomized controlled trial

被引:3
|
作者
Zeng, Huolin [1 ]
Yin, Feng [1 ]
Fan, Lingling [1 ,2 ]
Li, Chengyu [1 ,3 ]
Lin, Hongyan [1 ,4 ]
Liu, Fei [1 ]
Li, Qian [1 ]
机构
[1] Sichuan Univ, West China Hosp, Dept Anesthesiol, Guoxue Alley 37,Wuhou Dist, Chengdu 610041, Sichuan, Peoples R China
[2] Sichuan Sci City Hosp, Dept Anesthesiol, Mianyang 621900, Sichuan, Peoples R China
[3] Sichuan Univ, West China Hosp, Dept Clin Res Management, Chengdu 610041, Sichuan, Peoples R China
[4] Peoples Hosp Leshan, Dept Anesthesiol, Leshan 614000, Sichuan, Peoples R China
关键词
Gastric cancer; Transversus abdominis plane block; Adjuvants; Dexamethasone; Dexmedetomidine; Pain; CONSENSUS GUIDELINES; CLINICAL-TRIALS; PAIN; MANAGEMENT; SURGERY;
D O I
10.1016/j.jclinane.2024.111543
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Study objective: We conducted this double -blinded randomized controlled trial to examine whether the combination of dexamethasone and dexmedetomidine as adjuvants of transversus abdominis plane (TAP) block could improve analgesia efficacy and duration for gastric cancer patients. Design: Randomized controlled trial. Setting: The preoperative area, operating room, postanesthesia recovery room and bed ward. Patients: A total of 312 adult patients (104 per group) with gastric cancer were included. Interventions: Patients received bilateral subcostal TAP block with three different anesthetics (60 ml 0.25% ropivacaine added with 10 mg dexamethasone and 1 mu g center dot kg-1 dexmedetomidine [A] or 10 mg dexamethasone [B] or 1 mu g center dot kg-1 dexmedetomidine [C]). Measurements: The primary outcome was the incidence of moderate -to -severe pain 24 h on movement. Secondary outcomes included incidence of moderate -to -severe pain, pain score, opioids use, recovery quality and adverse events. Main results: The incidence of moderate -to -severe pain on movement 24 h postoperatively of group A was significantly lower than group B (45.19% vs 63.46%; RR 0.71; 95% CI, 0.55 to 0.92) and group C (45.19% vs 73.08%, RR 0.62; 95% CI, 0.49 to 0.79). The median moving pain scores decreased significantly at 24 h (3.00 [3.00,5.00] vs 4.00 [3.00,6.00] vs 4.00 [3.00,5.00]; P < 0.001). There were significant differences in the opioids consumption within the first 24 h (27.5 [17.0,37.2] vs 30.0 [20.0,42.0] vs 32.0 [25.0,44.0] mg; P = 0.01) and the duration to first rescue analgesia (65.5 +/- 26.7 vs 45.9 +/- 34.5 vs 49.2 +/- 27.2 h; P = 0.04). Conclusions: The combination with dexamethasone and dexmedetomidine as adjuvants for TAP block reduced the incidence of moderate -to -severe pain and pain score both on movement and at rest at 24 h with prolonged duration to first rescue analgesia after gastric cancer surgery.
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页数:9
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