Nagatsuka C, Ichinohe T, Kaneko Y
Department of Dental Anesthesiology, Tokyo Dental College, 1-2-2 Masago, Mihamaku, Chiba City 261-0011, Japan.
Anesth Prog. 2000 Winter;47(4):119-24.
The aim of the study was to investigate whether preemptive multimodal analgesia (diclofenac, butorphanol, and lidocaine) was obtained during sagittal split ramus osteotomy (SSRO). Following institutional approval and informed consent, 82 healthy patients (ASA-I) undergoing SSRO were randomly assigned to 1 of 2 groups, the preemptive multimodal analgesia group (group P, n = 41) and the control group (group C, n = 41). This study was conducted in a double-blind manner. Patients in group P received 50 mg rectal diclofenac sodium, 10 micrograms/kg intravenous 0.1% butorphanol tartrate, and 1% lidocaine solution containing 10 micrograms/mL epinephrine for regional anesthesia and for bilateral inferior alveolar nerve blocks before the start of surgery. Postoperative pain intensity at rest (POPI) was assessed on a numerical rating score (NRS) in the postanesthesia care unit (PACU) and on a visual analogue scale (VAS) at the first water intake (FWI) and at 24, 48, and 72 hours after extubation. POPI in the PACU was significantly lower in group P than in group C, whereas there were no significant differences at FWI, 24, 48, and 72 hours after extubation in both groups. Preemptive multimodal analgesia was not observed in this study.
本研究的目的是调查在矢状劈开下颌支截骨术（SSRO）期间是否能实现超前多模式镇痛（双氯芬酸、布托啡诺和利多卡因）。在获得机构批准并取得知情同意后，82例接受SSRO的健康患者（ASA-I级）被随机分为2组中的1组，即超前多模式镇痛组（P组，n = 41）和对照组（C组，n = 41）。本研究采用双盲方式进行。P组患者在手术开始前接受50 mg直肠双氯芬酸钠、10 μg/kg静脉注射0.1%酒石酸布托啡诺，以及含10 μg/mL肾上腺素的1%利多卡因溶液用于区域麻醉和双侧下牙槽神经阻滞。在麻醉后护理单元（PACU）采用数字评分量表（NRS）评估静息时的术后疼痛强度（POPI），在首次饮水时（FWI）以及拔管后24、48和72小时采用视觉模拟量表（VAS）评估。P组在PACU的POPI显著低于C组，而两组在FWI、拔管后24、48和72小时均无显著差异。本研究未观察到超前多模式镇痛效果。
