Relationship between the Use of Fentanyl-Based Intravenous Patient-Controlled Analgesia and Clinically Significant Events in Laparoscopic Gynecological Surgery: A Single-Center Retrospective Cohort Study.
Relationship between the Use of Fentanyl-Based Intravenous Patient-Controlled Analgesia and Clinically Significant Events in Laparoscopic Gynecological Surgery: A Single-Center Retrospective Cohort Study.
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妇科腹腔镜手术中芬太尼静脉自控镇痛与临床显著事件的关系：一项单中心回顾性队列研究。
DOI：
10.3390/jcm11113235
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发表时间：
2022-06-06
影响因子：
3.9
通讯作者：
Mizota, Toshiyuki
中科院分区：
文献类型：
--
作者：
Hamada, Miho;Takeda, Chikashi;Dong, Li;Hirotsu, Akiko;Shizuya, Izumi;Mizota, Toshiyuki
关键词：
背景：本研究探讨了芬太尼静脉病人自控镇痛(IvPCA)的使用与临床意义事件(CSE)发生率之间的关系，同时考虑了其在腹腔镜妇科手术中的镇痛效果和副作用。方法：这项研究包括2012-2018年间京都大学医院在全身麻醉下接受腹腔镜妇科手术的816名患者。主要暴露是使用以芬太尼为基础的ivPCA。我们定义了一种结果测量方法--CSE，它综合了严重的伤口疼痛和呕吐，被认为会对患者的康复产生负面影响。我们进行了多变量Logistic回归分析，以评估ivPCA使用和CSE之间的独立关系。结果：多变量Logistic回归分析显示，芬太尼静脉自控镇痛与CSE的增加独立相关(调整后的优势比(95%可信区间)：1.8(1.24-2.61)，p=0.002)。静脉自控镇痛的使用与术后严重伤口疼痛的发生率降低(调整后的优势比(95%可信区间)：0.5(0.27-0.9)，p=0.022)相关，但也与呕吐发生率的增加(调整后的优势比(95%可信区间)：2.65(1.79-3.92)，p<；0.001)相关。结论：芬太尼静脉自控镇痛在妇科腹腔镜手术中的应用与CSE增加有关。
Background: This study examined the relationship between the use of fentanyl-based intravenous patient-controlled analgesia (ivPCA) and the incidence of a clinically significant event (CSE), while considering both the analgesic effects and side effects in laparoscopic gynecological surgery. Methods: This study included 816 patients undergoing laparoscopic gynecological surgery under general anesthesia at Kyoto University Hospital between 2012 and 2018. The primary exposure was the use of fentanyl-based ivPCA. We defined an outcome measure—CSE—that integrates severe wound pain and vomiting assumed to negatively affect patient recovery. We performed multivariable logistic regression analysis to assess the independent relationship between ivPCA use and CSE. Results: Multivariable logistic regression analysis revealed that fentanyl-based ivPCA was independently associated with increased CSE (adjusted odds ratio (95% confidence interval): 1.80 (1.24–2.61), p = 0.002). Use of ivPCA was associated with a reduced incidence of postoperative severe wound pain (adjusted odds ratio (95% confidence interval): 0.50 (0.27–0.90), p = 0.022), but was also associated with an increased incidence of vomiting (adjusted odds ratio (95% confidence interval): 2.65 (1.79–3.92), p < 0.001). Conclusion: The use of fentanyl-based ivPCA in laparoscopic gynecological surgery is associated with increased CSE.
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影响因子：
9.8
作者：
Mizota, T.;Yamamoto, Y.;Kai, S.
通讯作者：
Kai, S.
影响因子：
2.9
作者：
Kim, Yu Yil;Moon, Soo Yeong;Kwon, Young Eun
通讯作者：
Kwon, Young Eun
影响因子：
2.8
作者：
Kim, Seong-Hyop;Oh, Chung-Sik;Lee, Sun Joo
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Lee, Sun Joo
影响因子：
2.8
作者：
Jung, Wol Seon;Kim, Yong Beom;Yang, Hong Seuk
通讯作者：
Yang, Hong Seuk
影响因子：
5.7
作者：
Mizota, Toshiyuki;Dong, Li;Kai, Shinichi
通讯作者：
Kai, Shinichi