经口机器人手术的强化康复方案可改善镇痛效果并减少麻醉药物使用。
Enhanced recovery protocol for transoral robotic surgery demonstrates improved analgesia and narcotic use reduction.
机构信息
Rush Medical College, Rush University Medical Center, Chicago, IL, United States of America.
Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, IL, United States of America.
出版信息
Am J Otolaryngol. 2020 Nov-Dec;41(6):102649. doi: 10.1016/j.amjoto.2020.102649. Epub 2020 Jul 15.
BACKGROUND
No study has evaluated the impact of the Enhanced Recovery After Surgery (ERAS) protocol on opioid usage among patients undergoing transoral robotic surgery (TORS).
METHODS
In this retrospective study, patients undergoing TORS were enrolled in an ERAS protocol and compared to control patients. Primary outcome measures included postoperative mean morphine equivalent dose (MED), Defense and Veterans Pain Rating Scale (DVPRS) pain scores, and opioid prescriptions on discharge.
RESULTS
The mean MED administered postoperatively was lower in the ERAS group (17.6 mg) than in the control group (65.0 mg) (p < .001). Average postoperative DVPRS scores were 2.9 in the ERAS group vs. 4.2 in the control group (p = .042). Fewer patients in the ERAS group received opioid prescriptions on discharge (31.6%) than controls (96.2%) (p < .001).
CONCLUSION
The TORS ERAS protocol is associated with reduced postoperative opioid usage, lower pain scores, and reduced opioid requirements on discharge.
背景
尚无研究评估强化术后康复（ERAS）方案对经口机器人手术（TORS）患者阿片类药物使用的影响。
方法
在这项回顾性研究中，纳入了接受 TORS 的患者，并将其纳入 ERAS 方案组与对照组进行比较。主要观察指标包括术后平均吗啡等效剂量（MED）、防御和退伍军人疼痛评定量表（DVPRS）疼痛评分以及出院时的阿片类药物处方。
结果
ERAS 组术后 MED 用量（17.6mg）低于对照组（65.0mg）（p<0.001）。ERAS 组术后平均 DVPRS 评分为 2.9 分，对照组为 4.2 分（p=0.042）。ERAS 组出院时开具阿片类药物处方的患者比例（31.6%）低于对照组（96.2%）（p<0.001）。
结论
TORS ERAS 方案与术后阿片类药物使用减少、疼痛评分降低以及出院时阿片类药物需求减少相关。
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