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单剂量对乙酰氨基酚和布洛芬预先给药后在鼻整形术中术后疼痛评分和阿片类药物消耗的比较评估:一项随机对照试验

Comparative Evaluation of Postoperative Pain Scores and Opioid Consumption in Septorhinoplasty After Administration of Single-Dose Preemptive Paracetamol and Ibuprofen: A Randomized Controlled Trial.

作者信息

Alshehri Ali Abdullah

机构信息

ORL&HNs and Facial Plastic Surgery, College of Medicine, Najran University, Najran, Kingdom of Saudi Arabia.

出版信息

Int Arch Otorhinolaryngol. 2023 Aug 4;27(3):e471-e477. doi: 10.1055/s-0042-1749386. eCollection 2023 Jul.

Abstract

Septorhinoplasty operates on the nose's bone and cartilage and is ensued by severe postoperative pain.  The objective of this study is to evaluate the effects of preoperative administration of intravenous (IV) paracetamol and ibuprofen on postoperative pain scores in patients undergoing septorhinoplasty.  A total of 150 patients undergoing septorhinoplasty were randomly assigned into 3 groups with 50 patients in each group. The control group (group A) was administered 100 ml saline solution; the paracetamol group (group B) was administered 1,000 mg of IV paracetamol in 100 ml of saline solution; and the ibuprofen group (group C) was administered 800 mg of IV ibuprofen in 100 ml of saline solution before surgery. Opioid analgesics were employed to achieve postoperative analgesia. Postoperative pain was evaluated using the visual analogue scale (VAS). Postoperative opioid consumption and adverse effects were also recorded for each patient.  In comparison with group A, the score in the VAS of groups B and C was statistically lower in all the time intervals (  < 0.05). In the 1 and 6 hours postoperatively, group C's score in the VAS in was lower than that of group B (  < 0.05). In the control group, total opioid consumption was highest in all time intervals (  < 0.05). In group C, total opioid consumption was significantly lower than in group B in the 0 to 6 and 6 to 12 hours intervals. (  < 0.05).  The single-dose preemptive administration of ibuprofen has a more profound postoperative analgesic effect than paracetamol in the first 6 hours after septorhinoplasty. After the first 6 hours postsurgery, there is no difference between ibuprofen and paracetamol in terms of analgesic effect.

摘要

鼻中隔成形术作用于鼻骨和软骨,术后会伴有剧痛。本研究的目的是评估术前静脉注射扑热息痛和布洛芬对接受鼻中隔成形术患者术后疼痛评分的影响。共有150例接受鼻中隔成形术的患者被随机分为3组,每组50例。对照组(A组)给予100毫升生理盐水;扑热息痛组(B组)给予100毫升生理盐水中含1000毫克静脉注射扑热息痛;布洛芬组(C组)在手术前给予100毫升生理盐水中含800毫克静脉注射布洛芬。采用阿片类镇痛药进行术后镇痛。使用视觉模拟量表(VAS)评估术后疼痛。还记录了每位患者术后阿片类药物的消耗量和不良反应。与A组相比,B组和C组在所有时间间隔的VAS评分均有统计学意义的降低(P<0.05)。术后1小时和6小时,C组的VAS评分低于B组(P<0.05)。在对照组中,所有时间间隔的阿片类药物总消耗量最高(P<0.05)。在C组中,0至6小时和6至12小时期间的阿片类药物总消耗量明显低于B组(P<0.05)。单剂量预先给予布洛芬在鼻中隔成形术后的前6小时比扑热息痛具有更显著的术后镇痛效果。术后6小时后,布洛芬和扑热息痛在镇痛效果方面没有差异。

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本文引用的文献

1
Acute Pain Management Following Facial Plastic Surgery.面部整形手术后的急性疼痛管理。
Otolaryngol Clin North Am. 2020 Oct;53(5):811-817. doi: 10.1016/j.otc.2020.05.010. Epub 2020 Jun 24.

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