Turan Alparslan, Karimi Nika, Zimmerman Nicole M, Mick Stephanie L, Sessler Daniel I, Mamoun Negmeldeen
Department of Outcomes Research, Anaesthesiology Institute, Cleveland Clinic, Cleveland, OH.
Department of Outcomes Research, Anaesthesiology Institute, Cleveland Clinic, Cleveland, OH.
J Cardiothorac Vasc Anesth. 2017 Dec;31(6):2058-2064. doi: 10.1053/j.jvca.2017.05.029. Epub 2017 May 17.
The authors investigated the hypothesis that perioperative acetaminophen reduces incisional pain at 30 and 90 days.
This was a prospective, randomized, double-blind trial.
Tertiary-care hospital (single center) cardiac surgery unit.
Patients undergoing cardiac surgery via median sternotomy.
Patients were assigned randomly to intravenous (IV) acetaminophen or IV placebo. Patients were given 4 doses of 1 g of IV acetaminophen or an equal volume of saline placebo over 15 minutes every 6 hours for 24 hours starting in the operating room after sternal closure.
Study participants were assessed by phone for incisional pain severity 30 and 90 days after surgery. Those reporting any incisional pain were asked to complete the Neuropathic Pain Questionnaire-Short Form and the modified Brief Pain Inventory. Patients were compared on 30- and 90-day incisional pain severity using separate multivariable linear regression models. IV acetaminophen had no effect on 30- and 90-day incisional pain, with an estimated difference in means (confidence interval) of 0.06 (-0.87 to 0.99) at 30 days (p = 0.88) and 0.07 (-0.71 to 0.86) at 90 days (p = 0.83). Low pain severity, neuropathic pain, and interference at both 30 and 90 days after surgery, regardless of treatment group, were observed.
IV acetaminophen did not reduce the incidence or intensity of incisional pain at 30 days and 90 days after surgery.
作者研究了围手术期使用对乙酰氨基酚可减轻术后30天和90天切口疼痛这一假设。
这是一项前瞻性、随机、双盲试验。
三级医疗医院（单中心）心脏外科病房。
接受正中开胸心脏手术的患者。
患者被随机分配接受静脉注射对乙酰氨基酚或静脉注射安慰剂。从手术室胸骨闭合后开始，每6小时在15分钟内给予患者4剂1克静脉注射对乙酰氨基酚或等体积的生理盐水安慰剂，共24小时。
在术后30天和90天通过电话评估研究参与者的切口疼痛严重程度。那些报告有任何切口疼痛的患者被要求完成简短形式的神经性疼痛问卷和改良的简明疼痛量表。使用单独的多变量线性回归模型比较患者在术后30天和90天的切口疼痛严重程度。静脉注射对乙酰氨基酚对术后30天和90天的切口疼痛没有影响，30天时平均差异（置信区间）估计为0.06（-0.87至0.99）（p = 0.88），90天时为0.07（-0.71至0.86）（p = 0.83）。无论治疗组如何，在术后30天和90天均观察到疼痛严重程度较低、神经性疼痛及干扰情况。
静脉注射对乙酰氨基酚并未降低术后30天和90天切口疼痛的发生率或强度。
