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腹腔镜卵巢囊肿切除术后患者自控镇痛与间断镇痛的满意度及疼痛缓解情况比较。

Comparison of satisfaction and pain relief between patients-controlled analgesia and interval analgesia after laparoscopic ovarian cystectomy.

作者信息

Bayar Ulkü, Basaran Mustafa, Atasoy Nuray, Ayoglu Hilal, Sade Hakan, Altunkaya Hanife

机构信息

Department of Obstetrics and Gynecology, Zonguldak Karaelmas University Faculty of Medicine, Zonguldak, Turkey.

出版信息

J Psychosom Obstet Gynaecol. 2008 Jun;29(2):139-45. doi: 10.1080/01674820701661112.

Abstract

Preoperative and postoperative psychological factors, postoperative pain, analgesic consumption, treatment satisfaction were compared in patients treated with intravenous patient-controlled analgesia (IV-PCA) or intramuscular analgesics after laparoscopic ovarian cystectomy. Thirty-one women with laparoscopically operated benign ovarian cysts were recruited in Zonguldak Karaelmas University Faculty of Medicine, Department of Obstetrics and Gynecology. Postoperatively sixteen women received morphine delivered by IV-PCA pump system and 15 women were prescribed another opioid (meperidine) intramuscularly. Two weeks before and one day after the surgery, Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) were self-administered. Afterwards, the operation visual analog scale (VAS) and satisfaction with pain control scale were recorded. Preoperative BDI and BAI scores of both groups were comparable. Postoperative BDI (7.9 +/- 7.2 versus 13.8 +/- 6.9, P = 0.03) and BAI (11.4 +/- 9.1 versus 17.4 +/- 6.2, P = 0.045) scores were significantly lower in the IV-PCA group. Morphine usage with PCA resulted in significantly higher pain scores than equivalent doses of meperidine administered intramuscularly (2.94 +/- 1.0 versus 1.67 +/- 0.7, P = 0.001). Although higher pain scores were obtained from IV-PCA group, self-reported satisfaction rates were higher in this group (8.3 +/- 1.1 versus 7.4 +/- 1.1, P = 0.04). Involvement of patients in their pain management might increase the awareness of pain but their satisfaction about the control of postoperative pain was significantly improved.

摘要

比较腹腔镜卵巢囊肿切除术后接受静脉自控镇痛(IV-PCA)或肌肉注射镇痛的患者术前和术后的心理因素、术后疼痛、镇痛药物用量及治疗满意度。宗古尔达克卡拉厄尔马斯大学医学院妇产科招募了31例接受腹腔镜手术的良性卵巢囊肿女性患者。术后,16例女性通过IV-PCA泵系统接受吗啡治疗,15例女性肌肉注射另一种阿片类药物(哌替啶)。手术前两周和手术后一天,患者自行填写贝克抑郁量表(BDI)和贝克焦虑量表(BAI)。之后,记录手术视觉模拟量表(VAS)及疼痛控制满意度量表。两组患者术前BDI和BAI评分具有可比性。IV-PCA组术后BDI(7.9±7.2对13.8±6.9,P = 0.03)和BAI(11.4±9.1对17.4±6.2,P = 0.045)评分显著更低。PCA使用吗啡导致的疼痛评分显著高于等效剂量肌肉注射哌替啶(2.94±1.0对1.67±0.7,P = 0.001)。尽管IV-PCA组疼痛评分更高,但该组患者自我报告的满意度更高(8.3±1.1对7.4±1.1,P = 0.04)。患者参与疼痛管理可能会提高对疼痛的认知,但他们对术后疼痛控制的满意度显著提高。

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