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加温加湿二氧化碳对腹腔镜手术患者术后疼痛、核心体温及恢复时间的影响:一项随机对照试验

The effect of heated humidified carbon dioxide on postoperative pain, core temperature, and recovery times in patients having laparoscopic surgery: a randomized controlled trial.

作者信息

Manwaring Janine M, Readman Emma, Maher Peter J

机构信息

Department of Endosurgery, University of Melbourne Department of Obstetrics and Gynecology, Mercy Hospital for Women, Heidelberg, Victoria, Australia.

出版信息

J Minim Invasive Gynecol. 2008 Mar-Apr;15(2):161-5. doi: 10.1016/j.jmig.2007.09.007.

Abstract

STUDY OBJECTIVE

To determine whether use of heated humidified carbon dioxide as insufflation gas during gynecologic laparoscopy reduced postoperative pain and hypothermia.

DESIGN

A randomized controlled trial (Canadian Task Force classification 1).

SETTING

A tertiary referral hospital.

PATIENTS

Sixty women scheduled for gynecologic laparoscopy between 30 and 90 minutes' duration.

INTERVENTIONS

Operative laparoscopic management of endometriosis, adhesions, or adnexal pathology.

MEASUREMENTS AND MAIN RESULTS

Sixty patients were randomized into either receiving heated humidified carbon dioxide (study group) or standard cold dry gas (control group). Intraoperative and postoperative core temperature, total analgesic use, postoperative nausea, and recovery room time were recorded. Postoperative pain intensity was assessed using visual analog scale. Statistical analysis was performed using software. No significant difference was revealed between groups with regard to postoperative pain, analgesic requirements, recovery room time, or postoperative nausea. The control group had less postoperative hypothermia, suggesting that external warming blankets may be more effective than heated humidified gas at maintaining intraoperative normothermia.

CONCLUSION

The use of heated humidified carbon dioxide insufflation for short-duration gynecologic laparoscopy up to 90 minutes' duration was not associated with any significant benefit with regard to postoperative pain, hypothermia, or time of recovery room stay.

摘要

研究目的

确定在妇科腹腔镜检查期间使用加热加湿二氧化碳作为气腹气体是否能减轻术后疼痛和体温过低。

设计

一项随机对照试验(加拿大工作组分类1)。

地点

一家三级转诊医院。

患者

60名计划进行持续30至90分钟妇科腹腔镜检查的女性。

干预措施

对子宫内膜异位症、粘连或附件病变进行腹腔镜手术治疗。

测量指标及主要结果

60名患者被随机分为接受加热加湿二氧化碳组(研究组)或标准冷干气体组(对照组)。记录术中和术后的核心体温、总镇痛药物用量、术后恶心情况及恢复室停留时间。使用视觉模拟量表评估术后疼痛强度。使用软件进行统计分析。两组在术后疼痛、镇痛需求、恢复室停留时间或术后恶心方面未显示出显著差异。对照组术后体温过低情况较少,这表明在维持术中正常体温方面,外部保暖毯可能比加热加湿气体更有效。

结论

对于持续时间长达90分钟的短期妇科腹腔镜检查,使用加热加湿二氧化碳气腹在术后疼痛、体温过低或恢复室停留时间方面未带来任何显著益处。

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