甲状腺手术后的术后疼痛评分及镇痛需求：三种术中阿片类药物方案的比较
Postoperative pain scores and analgesic requirements after thyroid surgery: comparison of three intraoperative opioid regimens.
作者信息
Motamed C, Merle J C, Yakhou L, Combes X, Vodinh J, Kouyoumoudjian C, Duvaldestin P
机构信息
Service d'Anesthesie Réanimation Hospital Henri Mondor, Créteil APHP, Université Paris 12, France.
出版信息
Int J Med Sci. 2006;3(1):11-3. doi: 10.7150/ijms.3.11. Epub 2006 Jan 1.
PURPOSE
This study was designed to compare the effect on postoperative pain, opioid consumption and the length of stay in postoperative care unit (PACU) after three different intraoperative analgesic regimens in thyroid surgery.
METHODS
Seventy five patients were enrolled into the study and assigned to one of three groups, fentanyl, sufentanil or remifentanil (n=25 for each group). Before the end of surgery, paracetamol 1 gr and nefopam 20 mg was also administered in all patients. Pain scores, opioid demand and the length of stay in PACU were assessed in a blind manner.
RESULTS
Post operative pain scores were significantly lower in the fentanyl and sufentanil groups compared to remifentanil group (55 +/- 15, and 60 +/- 10 versus 78+/- 12, P < 0.05). Patients in the remifentanil group stayed longer in the PACU 108+/- 37 min versus 78+/-31 and 73 +/- 25 min, (P< 0.05).
CONCLUSION
After remifentanil based analgesia, anticipation of postoperative pain with opioid analgesic appears mandatory even for surgery rated as being moderately painful, otherwise longer opioid titration due to higher pain scores might delay discharge time.
目的
本研究旨在比较甲状腺手术中三种不同的术中镇痛方案对术后疼痛、阿片类药物消耗量及术后监护病房（PACU）停留时间的影响。
方法
75例患者纳入本研究，分为三组，即芬太尼组、舒芬太尼组或瑞芬太尼组（每组25例）。在手术结束前，所有患者均给予对乙酰氨基酚1克和奈福泮20毫克。以盲法评估疼痛评分、阿片类药物需求量及PACU停留时间。
结果
与瑞芬太尼组相比，芬太尼组和舒芬太尼组术后疼痛评分显著更低（分别为55±15、60±10和78±12，P<0.05）。瑞芬太尼组患者在PACU停留时间更长（108±37分钟，而其他两组分别为78±31分钟和73±25分钟，P<0.05）。
结论
以瑞芬太尼为基础进行镇痛后，即使对于被评定为中度疼痛的手术，使用阿片类镇痛药来预期术后疼痛似乎也是必要的，否则由于疼痛评分较高导致更长时间的阿片类药物滴定可能会延迟出院时间。
Zotero 插件