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腹腔镜子宫切除术后围手术期度洛西汀用于疼痛管理:一项随机安慰剂对照试验。

Perioperative Duloxetine for Pain Management After Laparoscopic Hysterectomy: A Randomized Placebo-Controlled Trial.

机构信息

Department of Obstetrics and Gynecology, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey (Drs. Takmaz, Bastu, Ozbasli, Gundogan, Karabuk, Dede, Naki, Kose, and Gungor).

Department of Obstetrics and Gynecology, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey (Drs. Takmaz, Bastu, Ozbasli, Gundogan, Karabuk, Dede, Naki, Kose, and Gungor).

出版信息

J Minim Invasive Gynecol. 2020 Mar-Apr;27(3):665-672. doi: 10.1016/j.jmig.2019.04.028. Epub 2019 Aug 30.

Abstract

STUDY OBJECTIVE

To evaluate the effect of perioperative duloxetine on pain management in patients recovering from laparoscopic hysterectomy.

DESIGN

A randomized placebo-controlled trial.

SETTING

A university hospital.

PATIENTS

Of 100 patients enrolled, 80 were randomized 1:1 to receive perioperative duloxetine (n = 40) or placebo (n = 40).

INTERVENTIONS

Patients undergoing laparoscopic hysterectomy for benign conditions from November 2017 through March 2018 received 2 doses of 60 mg duloxetine or placebo 2 hours before and 24 hours after surgery.

MEASUREMENTS AND MAIN RESULTS

The Quality of Recovery (QoR)-40 questionnaire was completed by participants after discharge. Study and control groups were compared in terms of questionnaire scores, opioid analgesic use, and hospital length of stay. The baseline characteristics of the groups were comparable; median total QoR-40 scores were 111 of 200 and 112 of 200 for duloxetine and the placebo group, respectively; the difference did not reach statistical significance (p = .91). Although the physical independence subcomponent of the recovery questionnaire was improved in favor of duloxetine, none of the subcomponents reached statistical difference between groups. The groups did not differ in terms of postoperative narcotic analgesic use and hospital length of stay (p >.05).

CONCLUSION

Perioperative duloxetine did not reduce pain, need for narcotic analgesia, or hospital length of stay following laparoscopic hysterectomy.

摘要

研究目的

评估围手术期度洛西汀对腹腔镜子宫切除术患者疼痛管理的影响。

设计

随机安慰剂对照试验。

地点

一所大学医院。

患者

纳入的 100 名患者中,80 名按 1:1 随机分为围手术期度洛西汀组(n=40)或安慰剂组(n=40)。

干预措施

2017 年 11 月至 2018 年 3 月,因良性疾病接受腹腔镜子宫切除术的患者在手术前 2 小时和手术后 24 小时接受 2 剂 60 mg 度洛西汀或安慰剂。

测量和主要结果

参与者在出院后完成了 QoR-40 问卷。研究组和对照组在问卷评分、阿片类镇痛药使用和住院时间方面进行了比较。两组的基线特征相似;度洛西汀组和安慰剂组的总 QoR-40 评分中位数分别为 111 分(满分 200 分)和 112 分(满分 200 分);差异无统计学意义(p=0.91)。尽管恢复问卷的身体独立性子成分有利于度洛西汀,但组间差异均无统计学意义。两组在术后阿片类镇痛药使用和住院时间方面无差异(p>0.05)。

结论

围手术期度洛西汀不能减少腹腔镜子宫切除术后的疼痛、对阿片类镇痛药的需求或住院时间。

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