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沙丁胺醇/布地奈德在胸外科手术中联合使用对术后心肌损伤 (MINS) 的影响:一项前瞻性随机临床试验
Authors Lin S , Zhang Y, Huang X , Zhang X, Cheng E, Zhou Z, Liu J
Received 24 January 2023
Accepted for publication 24 March 2023
Published 1 April 2023 Volume 2023:17 Pages 1025—1036
DOI https://doi.org/10.2147/DDDT.S403638
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Tuo Deng
Purpose: This study aims to investigate whether the administration of salbutamol/budesonide reduced the incidence of myocardial injury in thoracic surgery.
Methods: The randomized controlled trial included 298 patients over 45 and at high-risk for cardiovascular complications after lobectomy. Patients in the experimental group were treated with salbutamol/budesonide after anesthesia induction with fiberoptic bronchoscope. The primary outcome was the incidence rates of myocardial injury, assessed before and three days after the operation. The secondary outcome was respiratory function at each time point during the operation, including lung compliance and arterial partial pressure of oxygen, postoperative pulmonary and cardiovascular complications, hospital stay, pain score, and analgesic dosage.
Results: In the control group, the incidence of myocardial injury was 57/150 (38%), while that in the experimental group was 33/148 (22%); compared between the two groups, the difference in the incidence of myocardial injury was statistically significant. The dynamic compliance and static compliance at half an hour after the start of surgery in the experimental group were significantly improved. Before leaving the operating room, the difference in arterial oxygen partial pressure between the two groups was statistically significant.
Conclusion: Intraoperative administration of salbutamol/budesonide reduced the incidence of myocardial injury after thoracic surgery, improved lung function, and reduced the incidence of postoperative pulmonary complications.
Keywords: salbutamol/budesonide, myocardial injury, thoracic surgery, cardiovascular risk, hsTnT, prediction model