Shiau Jieh-Min, Su Hao-Po, Chen Hung-Shu, Hung Kuo-Chuan, Lin Shung-Eing, Tseng Chia-Chih
Department of Anesthesiology, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Reg Anesth Pain Med. 2008 Jan-Feb;33(1):30-5. doi: 10.1016/j.rapm.2007.07.012.
Hemorrhoidectomy usually leads to severe postoperative pain that often causes urinary retention. Topical EMLA cream (lidocaine 2.5% and prilocaine 2.5%) has been used extensively in the clinical setting. This prospective study tested the effectiveness of EMLA cream for postoperative pain control after hemorrhoidectomy.
Thirty patients admitted for hemorrhoidectomy were enrolled and randomly assigned into either a control group (n = 15) or EMLA group (n = 15). Postoperatively, the control group received approximately 5 g of neomycin ointment, and the EMLA group received approximately 5 g of EMLA. A visual analog scale (VAS) score was recorded on arrival in the postanesthesia recovery unit (PAR), after 2 hours in the PAR, on the first postoperative evening, and on the first postoperative morning. The requested frequency and dosage of meperidine, the first spontaneous voiding time, the frequency of single urinary catheterization, and a patient satisfaction score were also obtained.
The VAS score and frequency and dosage of meperidine injections were significantly lower in the EMLA group than in the control group (P < .01). The voiding time was significantly later in the control group (P = .04). The frequency of single catheterization was significantly lower in the EMLA group than in the control group (P = .03). Patient satisfaction with postoperative pain control was significantly higher in the EMLA group than in the control group (P < .01). No systemic complications were observed.
Topical EMLA cream decreased pain intensity and meperidine requests, reduced the frequency of single catheterizations, and improved patient satisfaction with postoperative pain management after hemorrhoidectomy in adults.
痔切除术通常会导致严重的术后疼痛，常引发尿潴留。外用复方利多卡因乳膏（2.5%利多卡因和2.5%丙胺卡因）已在临床中广泛应用。本前瞻性研究旨在测试复方利多卡因乳膏在痔切除术后控制疼痛的有效性。
30例拟行痔切除术的患者入组并随机分为对照组（n = 15）和复方利多卡因乳膏组（n = 15）。术后，对照组给予约5 g新霉素软膏，复方利多卡因乳膏组给予约5 g复方利多卡因乳膏。在进入麻醉后恢复室（PAR）时、在PAR内2小时后、术后第一个晚上以及术后第一个早晨记录视觉模拟量表（VAS）评分。还获取了哌替啶的需求频率和剂量、首次自主排尿时间、单次导尿频率以及患者满意度评分。
复方利多卡因乳膏组的VAS评分以及哌替啶注射的频率和剂量显著低于对照组（P <.01）。对照组的排尿时间显著延迟（P =.04）。复方利多卡因乳膏组的单次导尿频率显著低于对照组（P =.03）。复方利多卡因乳膏组患者对术后疼痛控制的满意度显著高于对照组（P <.01）。未观察到全身并发症。
外用复方利多卡因乳膏可降低疼痛强度和哌替啶需求，减少单次导尿频率，并提高成人痔切除术后患者对疼痛管理的满意度。
