Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics and Gynecology, Good Samaritan Hospital, Cincinnati, OH 45220, USA.
Am J Obstet Gynecol. 2012 Nov;207(5):433.e1-6. doi: 10.1016/j.ajog.2012.06.040. Epub 2012 Jun 20.
To determine whether patient-controlled analgesia or scheduled intravenous analgesia provides superior pain relief and satisfaction with pain control after vaginal reconstructive surgery.
Fifty-nine women scheduled for vaginal reconstructive surgery were enrolled in this randomized trial. Operative procedures and postoperative orders were standardized. Visual analog scales for pain and satisfaction with pain control were recorded during the hospital stay and 2 weeks after surgery.
Patients receiving patient-controlled analgesia had less pain on postoperative day 1, 25 mm vs 39 mm, on visual analog scales (P = .007). Although this group used twice as much hydromorphone (3.57 mg vs 1.48 mg, P < .001), there was no difference in side effects, length of hospital stay, or complications. For the sample overall, larger amounts of narcotic used correlated with higher pain scores (r = 0.364, P = .009) and worse satisfaction scores (r = -0.348, P = .012).
In patients undergoing vaginal surgery, patient-controlled analgesia offers superior pain relief on postoperative day 1 when compared with scheduled, nurse-administered hydromorphone.
比较患者自控镇痛与计划性静脉镇痛用于阴道重建术后患者，哪种方式能提供更好的疼痛缓解效果和对疼痛控制的满意度。
本随机试验纳入了 59 例行阴道重建术的女性患者。手术过程和术后医嘱标准化。在住院期间和术后 2 周时，采用视觉模拟评分法评估疼痛和对疼痛控制的满意度。
接受患者自控镇痛的患者术后第 1 天疼痛评分更低，为 25mm 比 39mm（P=0.007）。尽管该组患者使用氢吗啡酮的量是计划性静脉镇痛组的两倍（3.57mg 比 1.48mg，P<0.001），但两组在副作用、住院时间或并发症方面无差异。对于总体样本，使用的麻醉药物量与疼痛评分（r=0.364，P=0.009）和满意度评分（r=-0.348，P=0.012）呈正相关。
在阴道手术患者中，与计划性静脉给予氢吗啡酮相比，患者自控镇痛在术后第 1 天能提供更好的疼痛缓解效果。
