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静脉注射对乙酰氨基酚和右旋酮洛芬在腰椎间盘手术后的术后疼痛和吗啡消耗的疗效。

Efficacy of intravenous paracetamol and dexketoprofen on postoperative pain and morphine consumption after a lumbar disk surgery.

机构信息

Department of Anesthesiology and Intensive Care, Cerrahpasa Medical Faculty, Istanbul University, 34098 Istanbul, Turkey.

出版信息

J Neurosurg Anesthesiol. 2013 Apr;25(2):143-7. doi: 10.1097/ANA.0b013e31827464af.

Abstract

BACKGROUND

We compared the analgesic effects of intravenous (IV) paracetamol with that of dexketoprofen on postoperative pain and morphine consumption during the first 24 hour after a lumbar disk surgery.

METHODS

This prospective, placebo-controlled, double blind study investigated the analgesic effects of IV paracetamol and dexketoprofen on postoperative pain, morphine consumption, and morphine-related side effects after a lumbar disk surgery. Sixty American Society of Anesthesiologists 1 or 2 status patients scheduled for elective lumbar disk surgery under general anesthesia were included in the study. Patients were treated using patient-controlled analgesia with morphine for 24 hours after a lumbar disk surgery and randomized to receive IV paracetamol 1 g, dexketoprofen 50 mg, or isotonic saline (placebo). The primary endpoint was pain intensity measured by the visual analogue scale, and secondary endpoints were morphine consumption and related side effects.

RESULTS

Pain intensity was lower in the dexketoprofen group (P=0.01) but not in the paracetamol group (P=0.21) when compared with the control group. Cumulative morphine consumption and morphine-related side effects did not reveal significant differences between the groups.

CONCLUSIONS

The study showed that pain intensity during 24 hours after the lumbar disk surgery was significantly lowered by dexketoprofen, but not with paracetamol, as a supplemental analgesic to morphine patient-controlled analgesia when compared with controls.

摘要

背景

我们比较了静脉注射(IV)扑热息痛和右旋酮洛芬在腰椎间盘手术后 24 小时内的镇痛效果以及吗啡的消耗量。

方法

本前瞻性、安慰剂对照、双盲研究调查了静脉注射扑热息痛和右旋酮洛芬对腰椎间盘手术后疼痛、吗啡消耗量和吗啡相关副作用的镇痛效果。60 名美国麻醉医师协会(ASA)1 级或 2 级择期行全身麻醉下腰椎间盘手术的患者纳入本研究。患者在腰椎间盘手术后接受 24 小时患者自控镇痛,并用吗啡治疗,并随机接受静脉注射扑热息痛 1g、右旋酮洛芬 50mg 或等渗盐水(安慰剂)。主要终点是通过视觉模拟评分法测量的疼痛强度,次要终点是吗啡消耗量和相关副作用。

结果

与对照组相比,右旋酮洛芬组的疼痛强度较低(P=0.01),但扑热息痛组无差异(P=0.21)。累积吗啡消耗量和吗啡相关副作用在各组之间无显著差异。

结论

该研究表明,与对照组相比,右旋酮洛芬作为吗啡患者自控镇痛的辅助镇痛药物,可显著降低腰椎间盘手术后 24 小时内的疼痛强度,但扑热息痛则没有。

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