Department of Obstetrics and Gynecology, St. Luke's-Roosevelt Hospital Center, New York, New York.
Obstet Gynecol. 2013 Mar;121(3):547-553. doi: 10.1097/AOG.0b013e318280da64.
To compare postoperative pain after conventional laparoscopic and robotically assisted laparoscopic surgery in gynecology.
This is a prospective nonrandomized analysis of patients undergoing conventional laparoscopy or robotically assisted laparoscopy in a university-affiliated hospital between March 2011 and March 2012. Postoperative pain was measured using the Numeric Rating Scale and the narcotic use converted to morphine sulfate equivalents. The primary outcome was the Numeric Rating Scale pain score obtained on the first postoperative day.
One hundred ten patients were enrolled; 91 were included in the statistical analysis. Both groups were similar with regard to race, history of abdominopelvic surgeries, psychiatric history, and substance abuse. Patients undergoing robotically assisted laparoscopy were 6 years older and had a body mass index 6 points higher. Median length of hospital stay for conventional laparoscopy and robotically assisted laparoscopy was 2 days and 3 days, respectively (P<.001); median to being off narcotics was 4 days and 4.5 days, respectively (P=.336); and median return to normal activities was 13 days and 21 days, respectively (P=.021). There were no significant differences in mean Numeric Rating Scale pain scores over time (P=.499) or mean narcotic requirements (P=.393) between groups.
Robotically assisted laparoscopy is equivalent to conventional laparoscopy in terms of subjective and objective measures of postoperative pain.
比较妇科常规腹腔镜手术和机器人辅助腹腔镜手术后的术后疼痛。
这是 2011 年 3 月至 2012 年 3 月期间在一所大学附属医院接受常规腹腔镜或机器人辅助腹腔镜手术的患者的前瞻性非随机分析。使用数字评分量表测量术后疼痛，并将麻醉药物用量转换为硫酸吗啡当量。主要结局是术后第 1 天的数字评分量表疼痛评分。
共纳入 110 例患者，其中 91 例纳入统计分析。两组在种族、腹部盆腔手术史、精神病史和药物滥用方面相似。接受机器人辅助腹腔镜手术的患者年龄大 6 岁，体重指数高 6 分。常规腹腔镜和机器人辅助腹腔镜的中位住院时间分别为 2 天和 3 天（P<.001）；中位停用麻醉药物的时间分别为 4 天和 4.5 天（P=.336）；中位恢复正常活动的时间分别为 13 天和 21 天（P=.021）。两组之间的数字评分量表疼痛评分的平均值（P=.499）或麻醉药物需求量的平均值（P=.393）在时间上均无显著差异。
机器人辅助腹腔镜手术在术后疼痛的主观和客观测量方面与常规腹腔镜手术相当。
