Szender J B, Hall K L, Kost E R
Clin Exp Obstet Gynecol. 2014;41(5):525-9.
Pain control and early ambulation are two important postoperative goals. Strategies that decrease morphine use while increasing ambulation have the potential to decrease postoperative complications. In this study the authors sought to determine the effect of an abdominopelvic binder on postoperative morphine use, pain, and ambulation in the first day after surgery.
The authors randomly assigned 75 patients undergoing abdominal gynecologic surgery to either binder or not after surgery. Demographic data and surgical characteristics were collected. Outcome variables included morphine use, pain score, time to ambulation, and number of ambulations.
A group at high risk for decreased mobility was identified and the binder increased the number of ambulatory events by 300%, 260%, and 240% in patients with vertical incisions, age over 50 years, and complex surgeries, respectively. Morphine use and pain scores were not significantly different.
The binder increased ambulations in the subset of patients at the highest risk for postoperative complications: elderly, cancer patients, and vertical incisions. Routine use of the binder may benefit particularly high-risk gynecologic surgical patients.
疼痛控制和早期活动是术后两个重要目标。减少吗啡使用量同时增加活动量的策略有可能降低术后并发症。在本研究中，作者试图确定腹部盆腔束腹带对术后首日吗啡使用量、疼痛及活动情况的影响。
作者将75例行腹部妇科手术的患者术后随机分为使用束腹带组和不使用束腹带组。收集人口统计学数据和手术特征。观察指标包括吗啡使用量、疼痛评分、开始活动时间及活动次数。
确定了活动能力下降高危组，束腹带使垂直切口患者、年龄超过50岁患者及复杂手术患者的活动次数分别增加了300%、260%和240%。吗啡使用量和疼痛评分无显著差异。
束腹带增加了术后并发症风险最高的患者亚组（老年人、癌症患者及垂直切口患者）的活动次数。常规使用束腹带可能对高危妇科手术患者尤其有益。
