Fischer S, Troidl H, MacLean A A, Koehler L, Paul A
Second Department of Surgery, University of Cologne, Germany.
Eur J Surg. 2000 Jul;166(7):545-51. doi: 10.1080/110241500750008619.
To evaluate the effectiveness of a new regimen of pre-emptive analgesia on the development of postoperative pain after inguinal hernia repair.
Prospective, double-blind, randomised study.
University Hospital, Germany.
70 consecutive patients who had primary unilateral inguinal hernia repairs.
A new regimen of pre-emptive analgesia with bupivacaine that was infiltrated preoperatively, intraoperatively, and postoperatively was tested. The control group were given saline infiltrations at the same times. Pain was measured up to postoperative day 30 using the visual analogue scale (VAS), the verbal rating scale (VRS), and by recording patient-controlled use of ibuprofen suppositories.
Pain was significantly less in the pre-emptive analgesia group than in the control group during the first 10 days postoperatively as assessed by VAS and VRS (p < 0.05). Analgesic consumption was also significantly reduced in the pre-emptive analgesia group (p < 0.05). Multivariate analysis showed that bupivacaine infiltration (pre-emptive analgesia) was associated with significantly less postoperative pain (p < 0.0001).
This regimen of pre-emptive analgesia is an effective and safe method of reducing postoperative pain and analgesic consumption after inguinal hernia repair.
评估一种新的超前镇痛方案对腹股沟疝修补术后疼痛发展的效果。
前瞻性、双盲、随机研究。
德国大学医院。
70例连续接受原发性单侧腹股沟疝修补术的患者。
测试一种新的布比卡因超前镇痛方案，该方案在术前、术中和术后进行浸润。对照组在相同时间给予生理盐水浸润。使用视觉模拟量表（VAS）、言语评定量表（VRS）并记录患者自控使用布洛芬栓剂，直至术后第30天测量疼痛情况。
通过VAS和VRS评估，超前镇痛组术后前10天的疼痛明显低于对照组（p<0.05）。超前镇痛组的镇痛药物消耗量也显著减少（p<0.05）。多变量分析表明，布比卡因浸润（超前镇痛）与术后疼痛显著减轻相关（p<0.0001）。
这种超前镇痛方案是一种有效且安全的方法，可减少腹股沟疝修补术后的疼痛和镇痛药物消耗量。
