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肌电图评估镇痛在治疗扁桃体切除术后疼痛中的作用:随机分组,初步报告。

EMG assessment of analgesia in treatment of posttonsillectomy pain: random allocation, preliminary report.

机构信息

Department of Otolaryngology—Head and Neck Surgery, Assaf Harofe Medical Center, Tel Aviv University, Israel.

出版信息

Clin J Pain. 2012 Feb;28(2):143-8. doi: 10.1097/AJP.0b013e3182272325.

Abstract

OBJECTIVES

Surface electromyographic (sEMG) study of posttonsillectomy swallow-evoked muscular reactions was performed to assess validity of EMG in evaluation of analgesic drugs.

METHODS

Sixty randomly chosen operated adults were divided into group 1 (n=30) treated with oxycodone, and group 2 (n=30) treated with placebo. Pain assessment included visual analog scale (VAS) pain score and EMG data: the timing, electric amplitude, and graphic patterns of muscular activity. We investigated masseter, infrahyoid, and submental-submandibular muscles. Records from trapezius muscle were used for control. The results were compared with previously established normative database. The sEMG data were compared with VAS score.

RESULTS

Oxycodone significantly reduced VAS pain score and changed muscle reactions to analgesia (amplitude) as was recorded by sEMG, whereas placebo reduced VAS pain score nonsignificantly and changed the reaction of the trapezius muscle only. Analgesia smoothes the recorded swallow peaks and increases time of deglutition. Statistically significant difference in muscle reactions was detected between the 2 groups.

CONCLUSIONS

sEMG might be used for quantitative evaluation of analgesic drugs by assessment of muscular reactions to pain and to analgesia. This method might add quantitative justification to the information obtained by VAS pain testing and clinical data.

摘要

目的

对扁桃体切除术后吞咽诱发的肌肉反应进行表面肌电图(sEMG)研究,以评估肌电图在评估镇痛药物方面的有效性。

方法

随机选择 60 名接受手术的成年人,分为 1 组(n=30)接受羟考酮治疗,2 组(n=30)接受安慰剂治疗。疼痛评估包括视觉模拟评分(VAS)疼痛评分和肌电图数据:肌肉活动的时间、电幅度和图形模式。我们研究了咀嚼肌、舌骨下肌和颏下-下颌下肌。斜方肌的记录用于对照。结果与先前建立的正常数据库进行比较。将 sEMG 数据与 VAS 评分进行比较。

结果

羟考酮显著降低了 VAS 疼痛评分,并改变了肌肉对镇痛的反应(幅度),而安慰剂则显著降低了 VAS 疼痛评分,仅改变了斜方肌的反应。镇痛使记录的吞咽峰值变平,并增加吞咽时间。两组之间的肌肉反应存在显著差异。

结论

sEMG 可用于通过评估疼痛和镇痛引起的肌肉反应来定量评估镇痛药物。这种方法可以为 VAS 疼痛测试和临床数据获得的信息提供定量依据。

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