Węgorowski Paweł, Stanisławek Andrzej, Domżał-Drzewicka Renata, Sysiak Justyna, Rząca Marcin, Milanowska Joanna, Janiszewska Mariola, Dziubińska Anna
Chair of Oncology and Environmental Health Care, Medical University of Lublin, Lublin, Poland.
The Second Department of Anaesthesiology and Intensive Care, Medical University of Lublin, Lublin, Poland.
Contemp Oncol (Pozn). 2016;20(2):158-64. doi: 10.5114/wo.2016.60071. Epub 2016 Jun 14.
Dynamic development of research on pain has resulted in the formulation of the concept of pre-emptive analgesia, which involves administration of analgesics before the first pain-producing stimulus appears. It is meant to prevent increased sensitivity to pain in the postoperative period. The aim of this study was to assess the possibilities of modifying the intensity of postoperative pain evaluated with the visual analogue scale (VAS) in patients after surgical treatment for breast neoplasm offered by pre-emptive analgesia.
The intensity of postoperative pain was measured immediately after the surgery as well as 6, 12, 18, and 24 hours later in 100 women who had undergone surgery for breast tumour. The correlation between experienced pain and the type of analgesic administered pre-emptively, including metamizole, tramadol, ketoprofen, and placebo was examined. The effect of other correlates such as the extensiveness of surgery, systolic and diastolic blood pressure, and heart rate on the level of experienced pain as well as the usefulness of physiological parameters for its assessment were also analysed.
The conducted study demonstrated the effectiveness of tramadol (p = 0.004) and ketoprofen (p = 0.039) administered half an hour before the beginning of surgery, but there was no similar effect in the case of metamizole (p = 1.0). A positive correlation was observed between the level of experienced pain and blood pressure values (p < 0.001). Heart rate does not seem to be significantly linked with the intensity of experienced pain (p = 0.157).
疼痛研究的动态发展导致了超前镇痛概念的形成，超前镇痛是指在首个产生疼痛的刺激出现之前给予镇痛药，旨在防止术后对疼痛的敏感性增加。本研究的目的是评估超前镇痛对接受乳腺肿瘤手术治疗的患者术后疼痛强度（采用视觉模拟评分法（VAS）评估）的改善可能性。
对100例接受乳腺肿瘤手术的女性患者，在术后即刻以及术后6、12、18和24小时测量其术后疼痛强度。研究了所经历的疼痛与超前给予的镇痛药类型（包括安乃近、曲马多、酮洛芬和安慰剂）之间的相关性。还分析了其他相关因素（如手术范围、收缩压和舒张压以及心率）对所经历疼痛水平的影响，以及生理参数对其评估的有用性。
所进行的研究表明，在手术开始前半小时给予曲马多（p = 0.004）和酮洛芬（p = 0.039）具有有效性，但安乃近则无类似效果（p = 1.0）。所经历的疼痛水平与血压值之间存在正相关（p < 0.001）。心率似乎与所经历的疼痛强度无显著关联（p = 0.157）。
