Arikan Osman Kursat, Ozcan Saziye, Kazkayasi Mustafa, Akpinar Serpil, Koc Can
Department of Otorhinolary-Head and Neck Surgery, Kirikkale University, Turkey.
J Otolaryngol. 2006 Jun;35(3):167-72.
To determine whether pre-emptive ropivacaine has an influence on postoperative pain in adult patients undergoing tonsillectomy.
A prospective, randomized, double-blind, placebo-controlled clinical trial.
University hospital.
The study included 20 adult patients undergoing elective tonsillectomy. Anesthetic induction and maintenance, dissection tonsillectomy, hemostasis techniques, and postoperative analgesic treatment were standardized for all patients. Before the onset of incision, one tonsillar fossa was administered 5 mL of 2% ropivacaine hydrochloride with epinephrine, whereas the other side received 5 mL of 0.9% saline with epinephrine and was designated as the control side.
For each side, postoperative pain, otalgia, operating time, amount of intraoperative blood loss, and postoperative hemorrhage were assessed. The intensity of postoperative pain was measured at rest and when the patient was drinking and was scored on a visual analogue scale. The patients were followed up for 10 days after surgery.
There was no statistically significant difference in the amount of intraoperative hemorrhage and operation time between sides (p > .05). The constant postoperative pain in the ropivacaine side at rest was significantly less than in the placebo side on days 1, 2, 5, and 6 (p < .05). The post-tonsillectomy pain experienced in the ropivacaine side when swallowing was significantly less than that in the placebo side throughout the study period except on day 10 (p < .05).
Based on the present findings, preincisional infiltration of ropivacaine 2% appears to be effective against both early and late postoperative pain, especially on swallowing, following tonsillectomy in adults.
确定预防性使用罗哌卡因是否对接受扁桃体切除术的成年患者术后疼痛有影响。
一项前瞻性、随机、双盲、安慰剂对照临床试验。
大学医院。
该研究纳入了20例接受择期扁桃体切除术的成年患者。所有患者的麻醉诱导和维持、扁桃体切除术、止血技术及术后镇痛治疗均标准化。在切口开始前,一侧扁桃体窝注射5毫升含肾上腺素的2%盐酸罗哌卡因,而另一侧注射5毫升含肾上腺素的0.9%生理盐水,作为对照侧。
评估每一侧的术后疼痛、耳痛、手术时间、术中失血量及术后出血情况。术后疼痛强度在静息时及患者饮水时测量,采用视觉模拟评分法评分。术后对患者进行10天随访。
两侧术中出血量和手术时间差异无统计学意义(p>0.05)。罗哌卡因侧静息时的持续性术后疼痛在第1、2、5和6天显著低于安慰剂侧(p<0.05)。除第10天外,在整个研究期间,罗哌卡因侧吞咽时扁桃体切除术后疼痛显著低于安慰剂侧(p<0.05)。
基于目前的研究结果,术前浸润2%罗哌卡因似乎对成年患者扁桃体切除术后的早期和晚期疼痛均有效,尤其是吞咽时的疼痛。