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静脉注射对乙酰氨基酚对腰椎间盘切除术后疼痛的影响。

The effect of intravenous paracetamol on postoperative pain after lumbar discectomy.

作者信息

Shimia Mohammad, Parish Masoud, Abedini Naghi

机构信息

Department of Neurosurgery, Tabriz University of Medical Sciences, Tabriz, Iran.

Department of Anesthesiology, Tabriz University of Medical Sciences, Tabriz, Iran.

出版信息

Asian Spine J. 2014 Aug;8(4):400-4. doi: 10.4184/asj.2014.8.4.400. Epub 2014 Aug 19.

Abstract

STUDY DESIGN

A randomized, double-blinded controlled trial.

PURPOSE

Postoperative pain relief especially using analgesic drugs with minimal side effects has considerable clinical importance. This study aimed to examine the effect of intravenous paracetamol on pain relief after lumbar discectomy as a major surgery.

OVERVIEW OF LITERATURE

Patients undergoing lumbar discectomy experience a high degree of lumbar pain. Some authors emphasize the use of intravenous paracetamol to improve postoperative pain and increase patients' satisfaction following this surgery.

METHODS

Fifty-two patients scheduled for lumbar discectomy were randomly allocated into two groups: a group that received intravenous paracetamol (1 g/100 mL normal saline) within the last 20 minutes of surgery as the case group (n=24) and a group that received sodium chloride 0.9% 100 mL as the control group (n=28). Postoperative pain was assessed at 1, 6, 12, 18, and 24 hours after surgery by a visual analogue scale (VAS). The dosage of the administered opioid (morphine), as well as drug-related side effects within the first 24 hours after surgery were also recorded.

RESULTS

The mean VAS score was significantly lower in the paracetamol group than the controls for all of the assessed time points. Although the dose of the administered morphine was numerically lower in the paracetamol group, this difference was not statistically significant (5.53±4.49 mL vs. 7.85±4.17 mL).

CONCLUSIONS

Intravenous paracetamol as a non-opioid analgesic can relieve postoperative pain in patients undergoing lumbar discectomy; however, its use alone may not represent the best regimen for reducing the needed dose of opioids after operation.

摘要

研究设计

一项随机、双盲对照试验。

目的

术后疼痛缓解,尤其是使用副作用最小的镇痛药具有重要的临床意义。本研究旨在探讨静脉注射对乙酰氨基酚作为一种主要手术方式,在腰椎间盘切除术后缓解疼痛的效果。

文献综述

接受腰椎间盘切除术的患者会经历高度的腰痛。一些作者强调使用静脉注射对乙酰氨基酚来改善术后疼痛,并提高患者对该手术的满意度。

方法

52例计划接受腰椎间盘切除术的患者被随机分为两组:一组在手术最后20分钟内接受静脉注射对乙酰氨基酚(1g/100mL生理盐水)作为病例组(n=24),另一组接受100mL 0.9%氯化钠作为对照组(n=28)。术后1、6、12、18和24小时通过视觉模拟评分法(VAS)评估术后疼痛。记录术后24小时内给予的阿片类药物(吗啡)剂量以及药物相关副作用。

结果

在所有评估时间点,对乙酰氨基酚组的平均VAS评分显著低于对照组。尽管对乙酰氨基酚组给予的吗啡剂量在数值上较低,但差异无统计学意义(5.53±4.49mL对7.85±4.17mL)。

结论

静脉注射对乙酰氨基酚作为一种非阿片类镇痛药可缓解腰椎间盘切除术后患者的疼痛;然而,单独使用它可能不是减少术后阿片类药物所需剂量的最佳方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc7c/4149981/d0b6af003ea5/asj-8-400-g001.jpg

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