Alessandri Franco, Lijoi Davide, Mistrangelo Emanuela, Nicoletti Annamaria, Crosa Marco, Ragni Nicola
Department of Obstetrics and Gynaecology, San Martino Hospital and University of Genoa, Genoa, Italy.
J Minim Invasive Gynecol. 2006 May-Jun;13(3):195-200. doi: 10.1016/j.jmig.2006.02.001.
STUDY OBJECTIVE: To compare pain management of standard analgesic and standard analgesic plus diclofenac transdermal patch in patients who undergo laparoscopic gynecologic surgery. DESIGN: Randomized prospective study (Canadian Task Force classification I). SETTING: University hospital. PATIENTS: One hundred twenty patients requiring laparoscopic surgery for gynecologic benign diseases. INTERVENTIONS: Patients were divided into two groups, one medicated with a diclofenac patch (diclofenac group) and the other medicated with standard skin medication (placebo; control group) at all incisional areas at the end of the operation. MEASUREMENTS AND MAIN RESULTS: The principal measures of outcome were pain intensity at 6, 12, and 24 hours after surgery and consumption of analgesics. The two treatment groups were comparable with respect to demographic and intraoperative characteristics. No significant difference was observed between the two groups in mean pain intensity at 6 hours after surgery. Mean pain intensity at 12 and 24 hours, respectively, after surgery was significantly lower in the diclofenac group (3.7 +/- 1.3 and 2.0 +/- 0.6) than that observed in the control group (5.7 +/- 1.9 and 4.6 +/- 0.5) (p value, respectively, .002 and <.001). Twenty-one patients (35.0%) in the diclofenac group required analgesics in the first 36 hours after the operation versus 43 patients (71.7%) in the control group (p <.001). Hospital discharge was significantly more rapid in the diclofenac group (28 +/- 5 hours vs 39 +/- 3 hours; p = .031). CONCLUSION: Diclofenac transdermal administration seems a valid help to standard analgesic treatment in postoperative pain control and could also help reduce the period of hospitalization of patients who undergo laparoscopic benign gynecologic surgery.
研究目的:比较标准镇痛剂与标准镇痛剂加双氯芬酸透皮贴剂对接受腹腔镜妇科手术患者的疼痛管理效果。 设计:随机前瞻性研究(加拿大工作组分类I级)。 地点:大学医院。 患者:120例因妇科良性疾病需行腹腔镜手术的患者。 干预措施:患者分为两组,一组在手术结束时于所有切口部位使用双氯芬酸贴剂(双氯芬酸组),另一组使用标准皮肤用药(安慰剂;对照组)。 测量指标及主要结果:主要结局指标为术后6、12和24小时的疼痛强度及镇痛药消耗量。两组在人口统计学和术中特征方面具有可比性。术后6小时两组平均疼痛强度无显著差异。双氯芬酸组术后12小时和24小时的平均疼痛强度分别为(3.7±1.3和2.0±0.6),显著低于对照组(5.7±1.9和4.6±0.5)(p值分别为0.002和<0.001)。双氯芬酸组21例患者(35.0%)在术后36小时内需使用镇痛药,而对照组为43例患者(71.7%)(p<0.001)。双氯芬酸组患者出院明显更快(28±5小时对39±3小时;p=0.031)。 结论:双氯芬酸经皮给药似乎对标准镇痛治疗控制术后疼痛有效,还可帮助缩短接受腹腔镜妇科良性手术患者的住院时间。
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