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[预防性镇痛技术对接受开放性鼻中隔成形术患者术后镇痛的有效性]

[The effectiveness of preemptive analgesic techniques on postoperative analgesia in patients undergoing open septorhinoplasty].

作者信息

Keskioğlu İlknur, Aktay İnal Meltem, Özlü Onur

机构信息

Department of Anesthesiology and Reanimation, Polatlı State Hospital, Ankara, Turkey.

Department of Anesthesiology and Reanimation, Osmaniye State Hospital, Osmaniye, Turkey.

出版信息

Agri. 2016 Jul;28(3):135-142. doi: 10.5505/agri.2015.17894.

Abstract

OBJECTIVES

A comparison was made of effects of preincisional intravenous (IV) dexketoprofen trometamol and acetaminophen on postoperative pain, analgesic requirement, hemodynamic parameters, postoperative tramadol consumption, and patient satisfaction in patients undergoing elective septorhinoplasty.

METHODS

Sixty patients scheduled for elective septorhinoplasty under general anesthesia were divided into 3 groups. Groups were similar with respect to gender, mean age, body weight, mean duration of surgery and anesthesia (p>0.05). Group D (n=20) received 50 mg IV dexketoprofen trometamol, while Group A (n=20) received 1 gr IV acetaminophen before surgical incision. Group K (n=20) received no analgesic. Postoperative analgesia was maintained with IV tramadol infusion, with the aid of patient-controlled analgesia pump. Visual analogue scale (VAS), total tramadol consumption, and patient satisfaction were recorded at 15 and 30 minutes postoperatively, as well as 1, 2, 6, 12, and 24 hours postoperatively.

RESULTS

VAS values were highest in Group K and lowest in Group D (p<0.001). There was no difference in tramadol consumption between Group K and Group A, but both groups consumed higher doses of tramadol than Group D (p=0.649 and p<0.05, respectively). First analgesic requirement time and side effects were similar in all groups.

CONCLUSION

It was observed that both preemptive IV dexketoprofen trometamol and acetaminophen were effective for postoperative analgesia in early postoperative period in elective septorhinoplasty under general anesthesia; however, preemptive dexketoprofen trometamol was more effective than acetaminophen for postoperative analgesia.

摘要

目的

比较术前静脉注射右酮洛芬氨丁三醇和对乙酰氨基酚对择期鼻中隔成形术患者术后疼痛、镇痛需求、血流动力学参数、术后曲马多用量及患者满意度的影响。

方法

60例计划在全身麻醉下进行择期鼻中隔成形术的患者被分为3组。各组在性别、平均年龄、体重、平均手术和麻醉持续时间方面相似(p>0.05)。D组(n=20)在手术切口前静脉注射50mg右酮洛芬氨丁三醇,而A组(n=20)在手术切口前静脉注射1g对乙酰氨基酚。K组(n=20)未接受任何镇痛药。术后镇痛通过静脉输注曲马多并借助患者自控镇痛泵维持。在术后15和30分钟以及术后1、2、6、12和24小时记录视觉模拟评分(VAS)、曲马多总用量及患者满意度。

结果

VAS值在K组最高,在D组最低(p<0.001)。K组和A组的曲马多用量无差异,但两组的曲马多用量均高于D组(分别为p=0.649和p<0.05)。所有组的首次镇痛需求时间和副作用相似。

结论

观察到,在全身麻醉下的择期鼻中隔成形术中,术前静脉注射右酮洛芬氨丁三醇和对乙酰氨基酚在术后早期均对术后镇痛有效;然而,术前使用右酮洛芬氨丁三醇比使用对乙酰氨基酚的术后镇痛效果更好。

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