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局部左旋布比卡因在功能性内窥镜鼻窦手术后疼痛控制中的效果。

Topical levobupivacaine efficacy in pain control after functional endoscopic sinus surgery.

机构信息

Düzce Medical Faculty ENT Department, Düzce, Turkey.

出版信息

Otolaryngol Head Neck Surg. 2013 Nov;149(5):777-81. doi: 10.1177/0194599813502925. Epub 2013 Sep 4.

Abstract

OBJECTIVE

The aim of this study was to find out the efficacy of a polyvinyl alcohol (PVA) sponge (Merocel Kennedy; Medtronic Xomed, Jacksonville, Florida) sinus pack soaked with levobupivacaine hydrochloride to control postoperative pain and analgesic need following functional endoscopic sinus surgery (FESS).

STUDY DESIGN

The study was designed as a prospective, double-blind, randomized, controlled study. Forty-one patients who underwent FESS were included in the analysis. Setting A tertiary referral hospital in Turkey.

MATERIALS AND METHODS

Patients who underwent FESS were divided into 2 groups. The PVA sponge sinus packs were soaked with 5 mL of levobupivacaine hydrochloride (chirocaine 25 mg/10 mL; Abbott, Nycomed Pharma AS, Elverum, Norway) in group I and with 5 mL of saline in group II.

MAIN OUTCOME MEASURES

Postoperative pain levels were recorded using a visual analog scale (VAS score, 0-100) at 30 minutes and 1, 2, 8, 12, and 24 hours.

RESULTS

There were no statistically significant differences between groups regarding age, sex, and American Society of Anesthesiologists status. Postoperative VAS values at 30 minutes and 1, 2, 8, 12, and 24 hours were significantly lower in group I than in group II (P < .05). Supplemental analgesia amount was significantly lower in group I than in group II (P = .003).

CONCLUSION

Using levobupivacaine-soaked PVA sponge sinus packs after FESS is an effective, easy, and quick method to control postoperative pain, and it improves patient comfort and tolerability.

摘要

目的

本研究旨在探讨经聚乙烯醇(PVA)鼻窦填塞海绵(Merocel Kennedy;Medtronic Xomed,杰克逊维尔,佛罗里达州)局部浸以盐酸左旋布比卡因对功能性鼻窦内镜手术(FESS)后控制术后疼痛和镇痛需求的效果。

研究设计

本研究设计为前瞻性、双盲、随机、对照研究。纳入 41 例行 FESS 的患者进行分析。

地点

土耳其一家三级转诊医院。

材料和方法

将行 FESS 的患者分为两组。I 组的 PVA 鼻窦填塞海绵用 5 mL 盐酸左旋布比卡因(chirocaine 25 mg/10 mL;Abbott,Nycomed Pharma AS,Elverum,挪威)浸泡,II 组用 5 mL 生理盐水浸泡。

主要观察指标

术后 30 分钟及 1、2、8、12 和 24 小时使用视觉模拟评分(VAS 评分,0-100)记录术后疼痛程度。

结果

两组患者的年龄、性别和美国麻醉医师协会(ASA)分级无统计学差异。I 组术后 30 分钟和 1、2、8、12 和 24 小时的 VAS 值明显低于 II 组(P<0.05)。I 组的辅助镇痛药物用量明显低于 II 组(P=0.003)。

结论

FESS 后使用盐酸左旋布比卡因浸 PVA 鼻窦填塞海绵是一种有效、简便、快速的控制术后疼痛的方法,可提高患者舒适度和耐受性。

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