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在控制疼痛的同时减少术后阿片类药物的使用:一项对接受阴囊手术男性的前瞻性研究。

Decreasing postoperative opioid use while managing pain: A prospective study of men who underwent scrotal surgery.

作者信息

Greer Aubrey B, Ramos Libert, Dubin Justin M, Ramasamy Ranjith

机构信息

Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA.

出版信息

BJUI Compass. 2020 May;1(2):60-63. doi: 10.1002/bco2.12. Epub 2020 Mar 20.

Abstract

OBJECTIVE

To compare postoperative pain control among men who received different quantities of narcotic prescriptions following scrotal surgery. We hypothesized that men receiving eight vs four pills of acetaminophen 300 mg/codeine 30 mg there would be no significant difference in mean pain following scrotal and inguinal surgery.

PATIENTS AND METHODS

In this prospective, open-label study, men who underwent scrotal surgery received eight or four acetaminophen 300 mg/codeine 30 mg pills. Men were encouraged to take scheduled non-steroidal anti-inflammatory drugs (NSAIDs), apply ice on the incision, and take acetaminophen 300 mg/codeine 30 mg as needed for breakthrough pain. Men were evaluated within 1-2 weeks after surgery. Statistical analysis was performed using Microsoft Excel and Stata/IC 15.1.

RESULTS

A total of eighty-seven men met inclusion criteria, fifty-four men received eight acetaminophen/codeine pills, and thirty-three men received four pills. There was no significant difference in mean pain score (0-10) of men receiving eight pills vs four pills in the week after surgery (3.6 ± 1.9 vs 3.3 ± 1.8, = .5004). Of men who used NSAIDs and ice, 93.5% and 92.3% found them to be moderately or very helpful.

CONCLUSION

Reducing the total prescription of combined narcotic/non-narcotic medication is not associated with increased postoperative pain in patients undergoing scrotal/inguinal surgery. There was no difference in postoperative pain in men taking eight or four acetaminophen 300 mg/codeine 30 mg pills. A limited prescription of eight or four pills was adequate for pain control in the majority of men who underwent scrotal surgery. NSAIDs and ice were found to be useful adjuncts for pain relief by those who used them.

摘要

目的

比较阴囊手术后接受不同剂量麻醉处方的男性患者的术后疼痛控制情况。我们假设,接受8片对乙酰氨基酚300毫克/可待因30毫克与4片的男性患者,在阴囊和腹股沟手术后的平均疼痛程度不会有显著差异。

患者与方法

在这项前瞻性、开放标签研究中,接受阴囊手术的男性患者服用8片或4片对乙酰氨基酚300毫克/可待因30毫克。鼓励患者按计划服用非甾体抗炎药(NSAIDs),在切口处冰敷,并根据需要服用对乙酰氨基酚300毫克/可待因30毫克以缓解突破性疼痛。术后1至2周对患者进行评估。使用Microsoft Excel和Stata/IC 15.1进行统计分析。

结果

共有87名男性符合纳入标准,54名男性服用8片对乙酰氨基酚/可待因片,33名男性服用4片。术后一周内,服用8片与4片的男性患者平均疼痛评分(0至10分)无显著差异(分别为3.6±1.9和3.3±1.8,P = 0.5004)。在使用NSAIDs和冰敷的患者中,93.5%和92.3%的人认为它们有中度或很大帮助。

结论

减少麻醉性/非麻醉性联合药物的总处方量与阴囊/腹股沟手术患者术后疼痛增加无关。服用8片或4片对乙酰氨基酚300毫克/可待因30毫克的男性患者术后疼痛无差异。对于大多数接受阴囊手术的男性患者,8片或4片的有限处方量足以控制疼痛。使用NSAIDs和冰敷的患者发现它们是缓解疼痛的有用辅助方法。

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