妇科恶性肿瘤开腹手术后:布比卡因脂质体vs盐酸布比卡因

2017-03-24 选题审校:韩茹 编辑:贾朝娟 环球医学

2016年11月,发表在《Obstet Gynecol》的一项研究调查了妇科恶性肿瘤开腹手术后布比卡因脂质体vs盐酸布比卡因的腹部切开注射相关的阿片使用和疼痛评估。研究结果显示,布比卡因脂质体腹部切口浸润与较少使用阿片和患者自控制性镇痛相关。




2016年11月,发表在《Obstet Gynecol》的一项研究调查了妇科恶性肿瘤开腹手术后布比卡因脂质体vs盐酸布比卡因的腹部切开注射相关的阿片使用和疼痛评估。研究结果显示,布比卡因脂质体腹部切口浸润与较少使用阿片和患者自控制性镇痛相关。

目的:调查妇科恶性肿瘤开腹手术后布比卡因脂质体vs盐酸布比卡因的腹部切开注射相关的阿片使用和疼痛评估。

方法:开展了一项回顾队列研究,用于比较在改善已有增强恢复途径后布比卡因脂质体和盐酸布比卡因的腹部切口浸润。对比更新途径治疗的经历分期性开腹手术或复杂细胞减少术患者和最初途径治疗的患者(历史对照)。终点包括口服等效量吗啡的累积阿片使用(主要结局)和累积疼痛得分。

结果:在复杂细胞减少术队列中,布比卡因脂质体组的中位口服等效量吗啡在24 h(30 vs 53.5 mg,P=0.002)、48 h(37.5 vs 82.5 mg,P=0.005)和住院期间(62 vs 100.5 mg,P=0.006)是较低的。布比卡因脂质体组较少的患者需要静脉注射抢救性阿片(28.9% vs 55.6%,P<0.001)或患者自控性镇痛(4.1% vs 33.3%,P<0.001)。48 h内两组间的累积疾病得分没有差异(161 vs 158,P=0.69)。布比卡因脂质体组患者的术后恶心和肠梗阻较少。两组的中位住院时间是5日。在分期性开腹手术队列中,两组的累积阿片量和累积疼痛得分没有差异(48 h内:162 vs 161,P=0.62;38 vs 38,P=0.68)。布比卡因脂质体组的静脉注射抢救性阿片(15.3% vs 28.6%,P=0.05)和患者自控性镇痛(1.4% vs 8.3%,P=0.05)较少。两组的中位住院时间是4日。尽管布比卡因脂质体价格较高,但两组间的总药物费用没有差异。

结论:在复杂性细胞减少术治疗妇科恶性肿瘤后,同盐酸布比卡因相比,布比卡因脂质体腹部切口浸润与较少使用阿片和患者自控制性镇痛相关,且疼痛得分没有变化。在经历分期性开腹手术的患者中,也可见到改善。


原始出处:
Kalogera E, Bakkum-Gamez JN, Weaver AL, et al.Abdominal Incision Injection of Liposomal Bupivacaine and Opioid Use After Laparotomy for Gynecologic Malignancies.Obstet Gynecol. 2016 Nov;128(5):1009-1017.

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (4)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1653793, encodeId=3f121653e935d, content=<a href='/topic/show?id=b374448088f' target=_blank style='color:#2F92EE;'>#妇科恶性肿瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44808, encryptionId=b374448088f, topicName=妇科恶性肿瘤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=840a24370605, createdName=lfcmxl, createdTime=Thu Aug 24 17:50:00 CST 2017, time=2017-08-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1976443, encodeId=ab9819e6443f8, content=<a href='/topic/show?id=06fd84425c8' target=_blank style='color:#2F92EE;'>#脂质体#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84425, encryptionId=06fd84425c8, topicName=脂质体)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ccbd84, createdName=shizhenshan, createdTime=Wed Jul 26 16:50:00 CST 2017, time=2017-07-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1659754, encodeId=209a1659e5424, content=<a href='/topic/show?id=c9564841325' target=_blank style='color:#2F92EE;'>#布比卡因脂质体#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48413, encryptionId=c9564841325, topicName=布比卡因脂质体)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=095c25021268, createdName=ying_wu, createdTime=Mon Jan 22 09:50:00 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1545961, encodeId=e1c5154596177, content=<a href='/topic/show?id=5d4a48412f1' target=_blank style='color:#2F92EE;'>#布比卡因#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48412, encryptionId=5d4a48412f1, topicName=布比卡因)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=321313846448, createdName=12498c32m72暂无昵称, createdTime=Sun Mar 26 07:50:00 CST 2017, time=2017-03-26, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1653793, encodeId=3f121653e935d, content=<a href='/topic/show?id=b374448088f' target=_blank style='color:#2F92EE;'>#妇科恶性肿瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44808, encryptionId=b374448088f, topicName=妇科恶性肿瘤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=840a24370605, createdName=lfcmxl, createdTime=Thu Aug 24 17:50:00 CST 2017, time=2017-08-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1976443, encodeId=ab9819e6443f8, content=<a href='/topic/show?id=06fd84425c8' target=_blank style='color:#2F92EE;'>#脂质体#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84425, encryptionId=06fd84425c8, topicName=脂质体)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ccbd84, createdName=shizhenshan, createdTime=Wed Jul 26 16:50:00 CST 2017, time=2017-07-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1659754, encodeId=209a1659e5424, content=<a href='/topic/show?id=c9564841325' target=_blank style='color:#2F92EE;'>#布比卡因脂质体#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48413, encryptionId=c9564841325, topicName=布比卡因脂质体)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=095c25021268, createdName=ying_wu, createdTime=Mon Jan 22 09:50:00 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1545961, encodeId=e1c5154596177, content=<a href='/topic/show?id=5d4a48412f1' target=_blank style='color:#2F92EE;'>#布比卡因#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48412, encryptionId=5d4a48412f1, topicName=布比卡因)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=321313846448, createdName=12498c32m72暂无昵称, createdTime=Sun Mar 26 07:50:00 CST 2017, time=2017-03-26, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1653793, encodeId=3f121653e935d, content=<a href='/topic/show?id=b374448088f' target=_blank style='color:#2F92EE;'>#妇科恶性肿瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44808, encryptionId=b374448088f, topicName=妇科恶性肿瘤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=840a24370605, createdName=lfcmxl, createdTime=Thu Aug 24 17:50:00 CST 2017, time=2017-08-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1976443, encodeId=ab9819e6443f8, content=<a href='/topic/show?id=06fd84425c8' target=_blank style='color:#2F92EE;'>#脂质体#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84425, encryptionId=06fd84425c8, topicName=脂质体)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ccbd84, createdName=shizhenshan, createdTime=Wed Jul 26 16:50:00 CST 2017, time=2017-07-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1659754, encodeId=209a1659e5424, content=<a href='/topic/show?id=c9564841325' target=_blank style='color:#2F92EE;'>#布比卡因脂质体#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48413, encryptionId=c9564841325, topicName=布比卡因脂质体)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=095c25021268, createdName=ying_wu, createdTime=Mon Jan 22 09:50:00 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1545961, encodeId=e1c5154596177, content=<a href='/topic/show?id=5d4a48412f1' target=_blank style='color:#2F92EE;'>#布比卡因#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48412, encryptionId=5d4a48412f1, topicName=布比卡因)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=321313846448, createdName=12498c32m72暂无昵称, createdTime=Sun Mar 26 07:50:00 CST 2017, time=2017-03-26, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=1653793, encodeId=3f121653e935d, content=<a href='/topic/show?id=b374448088f' target=_blank style='color:#2F92EE;'>#妇科恶性肿瘤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44808, encryptionId=b374448088f, topicName=妇科恶性肿瘤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=840a24370605, createdName=lfcmxl, createdTime=Thu Aug 24 17:50:00 CST 2017, time=2017-08-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1976443, encodeId=ab9819e6443f8, content=<a href='/topic/show?id=06fd84425c8' target=_blank style='color:#2F92EE;'>#脂质体#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84425, encryptionId=06fd84425c8, topicName=脂质体)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ccbd84, createdName=shizhenshan, createdTime=Wed Jul 26 16:50:00 CST 2017, time=2017-07-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1659754, encodeId=209a1659e5424, content=<a href='/topic/show?id=c9564841325' target=_blank style='color:#2F92EE;'>#布比卡因脂质体#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48413, encryptionId=c9564841325, topicName=布比卡因脂质体)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=095c25021268, createdName=ying_wu, createdTime=Mon Jan 22 09:50:00 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1545961, encodeId=e1c5154596177, content=<a href='/topic/show?id=5d4a48412f1' target=_blank style='color:#2F92EE;'>#布比卡因#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48412, encryptionId=5d4a48412f1, topicName=布比卡因)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=321313846448, createdName=12498c32m72暂无昵称, createdTime=Sun Mar 26 07:50:00 CST 2017, time=2017-03-26, status=1, ipAttribution=)]

相关资讯

Science:组蛋白单点突变可导致罕见儿童癌症

近日,国际学术期刊Science发表了一项最新研究进展,他们发现一种组蛋白编码基因发生缺陷与儿童恶性肿瘤的发生有关。来自美国威斯康星麦迪逊大学的Peter W. Lewis表示,大多数癌症的发生需要多个突变的共同作用,而他们发现的这个基因突变本身就足以导致形成肿瘤。组蛋白除了用于形成核小体,帮助进行基因组的压缩包装,还在基因的激活和沉默过程中发挥重要作用。有研究发现一些儿科肿瘤中包含高频的组蛋白H

杨莉教授:恶性肿瘤中基于基因组的个体化治疗

近年来肿瘤免疫治疗受到全球越来越多的关注,个体化医疗是目前国际上医学研究最前沿和最热门的方向,将当前大热的“免疫治疗”和“精准医学”结合起来,提供了独特的研究思路和视角。

新发恶性肿瘤 1/5是肺癌

本月是第16个“全球肺癌关注月”。昨日,北京晨报记者从市卫计委获悉,根据最新统计,每年5个新发恶性肿瘤中就有1个是肺癌,肺癌占据本市男性新发恶性肿瘤的第1位、女性的第2位,防控形势不容乐观。

Tomography:使用食糖来检测恶性肿瘤

根据一项最近发表于《Tomography》期刊的研究,普通食糖可能成为造影剂,未来用于核磁共振成像以检查肿瘤。与周围组织相比,恶性肿瘤表现出更高的糖消耗。 "如果糖能够替代金属作为体内造影剂,它还可以产生积极的心理效应,使患者更加平静"瑞典隆德大学高级讲师Linda Knutsson说道。 通过将少量的糖注入肿瘤然后测试其消耗糖的多少,可以检查肿瘤的属性。消耗的糖越多,肿瘤就越恶性。

Gastroenterology:英夫利昔单抗暴露与IBD小儿患者发生恶性肿瘤或HLH的风险增加无关!

来自于大型临床试验和SEER数据库的数据得到的对年龄、性别和种族进行调整后的SIRs,研究人员发现英夫利昔单抗暴露与IBD小儿患者发生恶性肿瘤或HLH的风险增加无关。巯基嘌呤暴露是IBD小儿患者发生恶性肿瘤或HLH的一个重要前提事件。

一文看懂「心力衰竭相关腹水」

正常状态下,人体腹腔内有少量液体(一般少于200ml),对肠道蠕动起润滑作用。任何病理状态下导致腹腔内液体量增加超过200ml时,称为腹水。腹水仅是一种病征,是很常见的临床表现之一,像下图这些样子。(图片来自网络)产生的主要原因有心血管病、肝脏病、腹膜病、肾脏病、营养障碍病恶性肿瘤腹膜转移卵巢肿瘤、结缔组织疾病等。对临床经验进行总结归纳后,腹水的主要原因有三个:肝硬化、恶性肿瘤和心力衰竭。通过腹部