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血清维生素 D 水平与腹腔镜胆囊切除术后急性术后疼痛和阿片类镇痛药物消耗有关:一项符合 STROBE 标准的前瞻性观察性研究。

Serum vitamin D le Serum vitamin D levels are associated with acute post e associated with acute postoperative pain and opioid analgesic consumption after laparoscopic cholecystect cholecystectomy: a str omy: a strobe compliant pr obe compliant prospectiv ospective obser e observational ational study.

机构信息

Department of Anesthesiology and Reanimation, Faculty of Medicine, Yozgat Bozok University, Yozgat, Turkey.

Department of Biochemistry, Faculty of Medicine, Yozgat Bozok University, Yozgat, Turkey.

出版信息

Turk J Med Sci. 2023 Feb;53(1):171-182. doi: 10.55730/1300-0144.5570. Epub 2023 Feb 22.

Abstract

BACKGROUND

In this prospective observational study, we aimed to evaluate the relationship between serum levels of vitamin D and acute postoperative pain scores, as well as opioid analgesic consumption in patients undergoing laparoscopic cholecystectomy.

METHODS

: The study was performed in the Medical Faculty Hospital, from April 2020 to April 2021. Postoperative visual analog scale (VAS) pain scores, total tramadol consumption, number of requests on patient-controlled analgesia (PCA) were compared between the vitamin D deficient (≤20 ng/mL; n = 25) and vitamin D nondeficient (>20 ng/mL; n = 55) groups at five time points (T0: in the recovery room, T1: 1st hour in the ward, T2: 6th hour, T3: 12th hour, and T4: 24th hour).

RESULTS

Postoperative VAS pain scores were similar in the vitamin D deficient group at all time points (T0-4), but differed significantly only at the T-0 time point (p = 0.020). The mean cumulative tramadol consumption was significantly higher in the vitamin D deficiency group than in the nondeficiency group (p = 0.005). Vitamin D levels were lower in patients with VAS ≥ 4 at the postoperative T-0 time point (p = 0.009). In the multivariate linear regression analysis, 15.7% of cumulative tramadol consumption was due to vitamin D deficiency (β = -0.188).

DISCUSSION

: Our study shows that preoperative low vitamin D level was associated with an increase in acute postoperative pain scores and consumption of opioid analgesics in patients undergoing laparoscopic cholecystectomy. Our findings may be useful for postoperative pain management in patients with vitamin D deficiency.

摘要

背景

在这项前瞻性观察研究中,我们旨在评估血清维生素 D 水平与行腹腔镜胆囊切除术患者的急性术后疼痛评分和阿片类镇痛药消耗之间的关系。

方法

该研究于 2020 年 4 月至 2021 年 4 月在医科大学附属医院进行。比较维生素 D 缺乏(≤20ng/mL;n=25)和维生素 D 非缺乏(>20ng/mL;n=55)组患者在五个时间点(T0:恢复室,T1:病房第 1 小时,T2:第 6 小时,T3:第 12 小时,T4:第 24 小时)的术后视觉模拟评分(VAS)疼痛评分、曲马多总消耗量和患者自控镇痛(PCA)请求次数。

结果

在所有时间点(T0-4),维生素 D 缺乏组的术后 VAS 疼痛评分相似,但仅在 T0 时间点差异有统计学意义(p=0.020)。维生素 D 缺乏组的累积曲马多消耗量明显高于非缺乏组(p=0.005)。术后 T0 时间点 VAS≥4 的患者维生素 D 水平较低(p=0.009)。在多元线性回归分析中,15.7%的累积曲马多消耗归因于维生素 D 缺乏(β=-0.188)。

讨论

我们的研究表明,术前低维生素 D 水平与腹腔镜胆囊切除术患者术后急性疼痛评分和阿片类镇痛药消耗增加有关。我们的研究结果可能对维生素 D 缺乏患者的术后疼痛管理有用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/efdd/10387885/69ad4dfbb99e/turkjmedsci-53-1-171f1.jpg

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