Edomwonyi N P, Osazuwa M O, Iribhogbe O I, Esangbedo S E
Department of Anaesthesiology, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria.
Department of Anaesthesia, National Hospital Abuja, Abuja, Nigeria.
Niger J Clin Pract. 2017 Dec;20(12):1584-1589. doi: 10.4103/njcp.njcp_232_16.
Effective management of postcesarean section (CS) pain is important for the well-being of mother and child; even in limited-resource areas, there are drug options which can be explored to achieve this.
This study aimed to compare the analgesic effects of a combination of bupivacaine wound infiltration with either intravenous (IV) dexamethasone or tramadol after CS.
This study was a randomized, double-blind, comparative study in a tertiary hospital. Clearance obtained from the Institution's Ethics and Research Committee.
One hundred and twenty American Society of Anesthesiologists I or II pregnant women scheduled for CS under spinal anesthesia were recruited after giving consent. At the end of skin closure, all the patients received 20 ml of 0.1% plain bupivacaine for wound infiltration and IV dexamethasone 8 mg (Group BD) or tramadol 100 mg (Group BT). Outcome measures were time to first analgesic request, visual analog scale (VAS) scores, side effects, and patients' satisfaction.
Time to first analgesic request was 3.2 ± 1.87 and 3.3 ± 2.01 h for BD and BT groups, respectively (P = 0.778). VAS scores for the first 2 h were lower in the bupivacaine/tramadol group compared to bupivacaine/dexamethasone group; the differences were statistically significant at 30 and 60 min (P = 0.027 and 0.008), respectively. Ninety percent versus 93% of the patients in BD and BT groups, respectively, expressed good to excellent satisfaction with pain relief.
Combination of bupivacaine wound infiltration and IV tramadol provided better quality pain relief.
剖宫产术后疼痛的有效管理对母婴健康至关重要；即使在资源有限的地区，也有一些药物选择可供探索以实现这一目标。
本研究旨在比较布比卡因伤口浸润联合静脉注射地塞米松或曲马多在剖宫产术后的镇痛效果。
本研究是在一家三级医院进行的随机、双盲、对照研究。获得了该机构伦理与研究委员会的批准。
120例美国麻醉医师协会分级为I或II级、计划在腰麻下行剖宫产的孕妇在签署知情同意书后被纳入研究。在皮肤缝合结束时，所有患者均接受20 ml 0.1%的普通布比卡因进行伤口浸润，并静脉注射8 mg地塞米松（BD组）或100 mg曲马多（BT组）。观察指标包括首次镇痛需求时间、视觉模拟评分（VAS）、副作用及患者满意度。
BD组和BT组的首次镇痛需求时间分别为3.2±1.87小时和3.3±2.01小时（P = 0.778）。布比卡因/曲马多组前2小时的VAS评分低于布比卡因/地塞米松组；在30分钟和60分钟时差异有统计学意义（分别为P = 0.027和0.008）。BD组和BT组分别有90%和93%的患者对疼痛缓解表示满意至非常满意。
布比卡因伤口浸润联合静脉注射曲马多能提供更好的疼痛缓解效果。
