O'Neal M G, Beste T, Shackelford D P
Department of Obstetrics and Gynecology, Brody School of Medicine, East Carolina University, Medical Center Annex, Greenville, NC 27858, USA.
Am J Obstet Gynecol. 2003 Dec;189(6):1539-41; discussion 1541-2. doi: 10.1016/j.ajog.2003.10.691.
Our purpose was to determine whether preemptive administration of long-acting local anesthetics before vaginal hysterectomy will improve postoperative pain.
A blinded, randomized, trial of paracervical injection of 0.5% bupivacaine with epinephrine or normal saline solution placebo with epinephrine was conducted. Verbal analog pain scores were collected at 1, 2, 3, 4, 6, and 24 hours after surgery. Morphine use in the postanesthesia care unit and by patient-controlled morphine analgesia was recorded.
Twenty patients were enrolled. Nine were randomized to bupivacaine. There was no difference between groups regarding age, length of surgery, blood loss, or length of stay. Pain scores were lower in the bupivacaine group by analysis of variance (P=.03). Total morphine and patient-controlled analgesia morphine was significantly less in patients receiving bupivacaine (P=.01 and.04).
Paracervical block with a 0.5% bupivacaine with 1:200,000 epinephrine before vaginal hysterectomy is associated with lower pain scores and a reduction in morphine requirements after surgery.
我们的目的是确定在阴道子宫切除术之前预先给予长效局部麻醉剂是否会改善术后疼痛。
进行了一项双盲、随机试验，对宫颈旁注射含肾上腺素的0.5%布比卡因或含肾上腺素的生理盐水安慰剂进行研究。在术后1、2、3、4、6和24小时收集语言模拟疼痛评分。记录在麻醉后护理单元中吗啡的使用情况以及患者自控吗啡镇痛的使用情况。
招募了20名患者。9名被随机分配到布比卡因组。两组在年龄、手术时间、失血量或住院时间方面没有差异。通过方差分析，布比卡因组的疼痛评分较低（P = 0.03）。接受布比卡因治疗的患者的总吗啡用量和患者自控镇痛吗啡用量显著较少（P = 0.01和0.04）。
阴道子宫切除术之前用含1:200,000肾上腺素的0.5%布比卡因进行宫颈旁阻滞与较低的疼痛评分以及术后吗啡需求量减少有关。
