机构：[1]National Clinical ResearchCenter for Geriatric Disorders,Beijing, China[2]Department of Anesthesiology, Xuanwu Hospital,Capital Medical University,Beijing, China外科系统麻醉手术科首都医科大学宣武医院[3]Daxing HospitalAffiliated to Capital Medical,Xingfeng Street, Daxing District,Beijing, China[4]Department of Radiology, Xuanwu Hospital,Capital Medical University,Beijing, China医技科室放射科首都医科大学宣武医院[5]Department of Neurosurgery, Xuanwu Hospital,Capital Medical University,Beijing, China神经科系统神经外科首都医科大学宣武医院
出处：
ISSN：
摘要：
Percutaneous nephrolithotomy (PCNL) is the first-line and guideline-recommended treatment for large renal calculi. Multimodal analgesia (MMA) comprising a combination of different analgesics is an increasingly popular method for pain control as it has been shown to reduce postoperative pain and reduce opioid use and the risk of opioid misuse, with a shorter recovery time in various procedures and patient populations.In this study, we tested the hypothesis that MMA with propofol and sevoflurane (PS) can decrease pain intensity during surgery and used IoC2 as a real-time index of the analgesic effect of sevoflurane.Prospective, single-center, double-blind, randomized controlled clinical trial.Xuanwu Hospital of Capital Medical University.Patients scheduled for elective percutaneous nephrolithotomy from January 2020 to July 2020 were randomized into 2 groups, standard multimodal analgesia (propofol + sevoflurane group) and control (propofol [P] group). The PS group received propofol 2.5 mg/kg/h along with 1% sevoflurane after induction for 30 minutes during the main anesthetic procedure, and the P group received propofol 5 mg/kg/h by intravenous infusion during the operation. Index of consciousness 2 (IoC2), namely nociception index, intraoperative hemodynamic fluctuation, bispectral index (BIS), electromyography, postanesthesia care unit (PACU) length of stay, visual analog scale (VAS) score, and Aldrete and Steward scores were recorded.A total of 153 patients undergoing PCNL were enrolled. The demographic and clinical characteristics were similar between the 2 groups. IoC2 was reduced in the PS group compared to the P group at T10, T11, T12, T13, T14, and T15 time points, indicating that analgesia was more effective in the former. The BIS of the PS group did not differ significantly from that of the P group except at T12, T13, T14, and T15. PACU length of stay was shorter in the PS group than in the P group (mean [SD]: 54.35 [16.61] vs 47.39 [13.15], P = 0.04). VAS pain scores did not differ significantly between the 2 groups.MMA with propofol and sevoflurane provided better analgesia than propofol alone and may be an effective method to reduce stress and the intraoperative nociceptive stimulus response in patients undergoing PCNL, thereby promoting rapid postoperative recovery.
第一作者机构：[1]National Clinical ResearchCenter for Geriatric Disorders,Beijing, China
通讯作者：
通讯机构：[1]National Clinical ResearchCenter for Geriatric Disorders,Beijing, China[*1]Department of Anesthesiology, Xuanwu Hospital Capital Medical University, Beijing 100053, China
推荐引用方式(GB/T 7714)：
Wang Xiao-Hua,Zhang Si-Yuan,Huang Yi,et al.Multimodal Analgesia With Sevoflurane Provides Enhanced Intraoperative Analgesic Effects in Percutaneous Nephrolithotomy: A Randomized, Blinded Clinical Trial.[J].PAIN PHYSICIAN.2022,25(3):283-+.
APA：
Wang Xiao-Hua,Zhang Si-Yuan,Huang Yi,Wang Qian,Zou Luwen...&Wang Tian-Long.(2022).Multimodal Analgesia With Sevoflurane Provides Enhanced Intraoperative Analgesic Effects in Percutaneous Nephrolithotomy: A Randomized, Blinded Clinical Trial..PAIN PHYSICIAN,25,(3)
MLA：
Wang Xiao-Hua,et al."Multimodal Analgesia With Sevoflurane Provides Enhanced Intraoperative Analgesic Effects in Percutaneous Nephrolithotomy: A Randomized, Blinded Clinical Trial.".PAIN PHYSICIAN 25..3(2022):283-+
