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首页> 外文期刊>The Open Anesthesia Journal >Increased Nociception Following Administration of Different Doses of Tranexamic Acid in Adolescent Idiopathic Scoliosis Surgery
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Increased Nociception Following Administration of Different Doses of Tranexamic Acid in Adolescent Idiopathic Scoliosis Surgery

机译：青少年特发性脊柱侧凸手术中不同剂量的氨甲环酸给药后增加的伤害感受

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Background: The inhibitory effect of Tranexamic Acid (TXA) on γ-aminobutyric acid and glycine receptors of spinal dorsal horn neurons which leads to pain arousal, has been highlighted recently in animal studies. Such findings would elicit concerns about adverse effects of TXA as a routine agent used to reduce perioperative blood loss. Objectives: This study aimed to evaluate the effect of different doses of TXA on analgesic requirements in adolescent patients undergoing elective single-stage posterior spine fusion surgery for idiopathic scoliosis. Patients and Methods: This prospective, randomized, double-blinded study comprised 75 patients who were randomly allocated to one of three groups. Each group comprised 25 patients. In group C (Control), patients received normal saline. While in group HD (High Dose), patients received TXA with a loading dose of 50 mg/kg and maintenance dose of 20 mg/kg/h and patients in group LD (Low Dose) received TXA with a loading dose of 10 mg/kg and maintenance dose of 1 mg/kg/h. The total intraoperative fentanyl dose was calculated for each patient which we used as a measure of the patients’ nociception level. Results: Group HD patients’ required the highest dose of fentanyl compared to those in LD group (mean of 60μg versus 27μg). Patients in group C received no extra intraoperative narcotic doses and experienced the longest duration of surgical procedure. These results showed high statistically significant difference (p < 0.001). Conclusion: Intraoperative administration of TXA increases the analgesic requirement during elective single stage posterior spine fusion surgery which likely reflects an increase in patients’ intraoperative nociception.
机译：背景：最近在动物研究中已经强调了氨甲环酸（TXA）对脊髓背角神经元的γ-氨基丁酸和甘氨酸受体的抑制作用，这种刺激可引起疼痛觉醒。这些发现将引起人们对TXA作为减少围手术期失血的常规药物的不良反应的担忧。目的：本研究旨在评估针对特发性脊柱侧弯进行选择性单期后路脊柱融合手术的青少年患者，不同剂量的TXA对镇痛需求的影响。患者和方法：这项前瞻性，随机，双盲研究包括75位患者，这些患者被随机分配到三组之一。每组包括25名患者。在C组（对照组）中，患者接受了生理盐水。在HD组（高剂量）中，患者接受TXA的负荷剂量为50 mg / kg，维持剂量为20 mg / kg / h，而LD组（低剂量）的患者则接受TXA的负荷剂量为10 mg / kg / h千克，维持剂量为1毫克/千克/小时。计算每位患者的术中芬太尼总剂量，以此作为衡量患者的伤害感受水平的指标。结果：与LD组相比，HD组患者需要的芬太尼剂量最高（平均60μg对27μg）。 C组患者未接受额外的术中麻醉剂量，并且手术时间最长。这些结果显示出极高的统计学显着性差异（p <0.001）。结论：术中给予TXA会增加选择性单期后路脊柱融合手术期间的镇痛要求，这可能反映出患者术中的伤害感受有所增加。

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