面部区域皮肤切口使用手术刀与电刀后的疼痛评估
Evaluation of Pain Following the Use of Scalpel Versus Electrosurgery for Skin Incisions in the Facial Regions.
作者信息
Peneva Margarita, Gjorgjeska Andrijana, Gjorgova Smilja Tudzarova, Dzonov Boro, Noveski Lazo, Ginoski Vladimir, Tolevska Roza Dzoleva, Breshkovska Hristina
机构信息
University Clinic for Plastic and Reconstructive Surgery, Medical Faculty, Ss. Cyril and Methodius University, Skopje, Republic of Macedonia.
University Clinic for Orthopedic surgery, Medical Faculty, Ss. Cyril and Methodius University, Skopje, Republic of Macedonia.
出版信息
Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2018 Dec 1;39(2-3):107-112. doi: 10.2478/prilozi-2018-0048.
INTRODUCTION
Postoperative pain presents a significant medical problem. It can create a considerable discomfort in the immediate postoperative period and thus increase patient's morbidity. Multiple mechanisms are involved in its' etiology, one of them being the method of tissue incision. The aim of this study is to compare the early postoperative pain following incision with two different methods, scalpel and electrosurgery in the facial regions.
MATERIAL AND METHODS
Eighty patients with both benign and malignant skin lesions in the facial regions undergoing surgery were enrolled in this study. Patients were randomized in two groups. In group A, comprising 40 patients, cold steel surgical scalpel №15 was used for the surgical procedure. Electrosurgical microneedle with 0.06mm tip radius and generator unit KLS Martin Electrosurgical Unit ME MB 2 set on cutting mode, power 12 W was used for performing the surgery in group B including the same number of patients. After the surgery patients were given analgesics on their demand. The total number of on demand analgesics requirements was calculated. The patients were also asked to note the oral analgesics they were taking after being released from the hospital.
RESULTS
Results of this study showed a statistically significant difference between the groups in the analgesics demand on the day of the operation (p=0.041). On the day of the operation 52.5% patients in the scalpel group and only 30% of the patents of the electrosurgery group received analgesics on demand. In all other analysed time points, the patients in the scalpel group received analgesics more often than the patients in the microneedle group, but with no statistically confirmed difference between the groups (p>0.05). Even more significant is the fact that patients treated with electrosurgery that needed analgesics, had significantly bigger excision area median 471 (rank 283-589) compared to the patients treated with the conventional method 289 (rank 177-432) (p=0.016).
CONCLUSION
In accordance with previous studies our results suggested a significantly reduced postoperative pain in the electrosurgery group.
引言
术后疼痛是一个重大的医学问题。它会在术后即刻造成相当大的不适，从而增加患者的发病率。其病因涉及多种机制，其中之一是组织切开方法。本研究的目的是比较面部区域采用手术刀和电外科两种不同方法切开后的早期术后疼痛情况。
材料与方法
本研究纳入了80例面部患有良性和恶性皮肤病变并接受手术的患者。患者被随机分为两组。A组有40例患者，手术过程中使用冷钢15号手术刀。B组有40例患者，手术中使用尖端半径为0.06mm的电外科微针和KLS Martin电外科设备ME MB 2，并设置为切割模式，功率12W。术后患者按需给予镇痛药。计算按需使用镇痛药的总数。患者还被要求记录出院后服用的口服镇痛药。
结果
本研究结果显示，两组在手术当天的镇痛药需求量上存在统计学显著差异（p = 0.041）。手术当天，手术刀组52.5%的患者按需接受了镇痛药，而电外科组只有30%的患者按需接受了镇痛药。在所有其他分析的时间点，手术刀组患者比微针组患者更频繁地接受镇痛药，但两组之间无统计学确认的差异（p>0.05）。更显著的是，与采用传统方法治疗的患者相比，接受电外科治疗且需要镇痛药的患者切除面积中位数显著更大，分别为471（秩次283 - 589）和289（秩次177 - 432）（p = 0.016）。
结论
与先前的研究一致，我们的结果表明电外科组术后疼痛显著减轻。
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