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使用降噪耳机隔离噪音对减少腹腔镜手术后疼痛的效果:一项随机临床试验。

Effect of noise isolation using noise-cancelling headphones during laparoscopic surgery for postoperative pain reduction: A randomized clinical trial.

机构信息

Department of Anesthesiology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China.

Department of Anesthesiology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China.

出版信息

J Clin Anesth. 2024 Feb;92:111286. doi: 10.1016/j.jclinane.2023.111286. Epub 2023 Oct 12.

Abstract

STUDY OBJECTIVE

Most laparoscopic surgeries under general anesthesia are performed in noisy environments, although the effect of intraoperative noise reduction on postoperative pain remains uncertain. This study aimed to explore whether postoperative pain could be reduced through the intraoperative use of noise-cancelling headphones.

DESIGN

This study was conducted as a prospective parallel-group randomized clinical trial.

SETTING

Operating room and surgery room.

PATIENTS

Ninety patients who underwent laparoscopic surgery under general anesthesia.

INTERVENTIONS

In the intervention group, noise-cancelling headphones were used to reduce noise intensity during laparoscopic surgery under general anesthesia.

MEASUREMENTS

The primary outcome was the maximum movement-evoked pain intensity within 24 h post-surgery, measured using a 10-point numeric rating scale. Secondary outcomes included the maximum resting pain score and total opioid consumption during the 24-h period post-surgery. Mean intraoperative noise and the proportion of intraoperative time with noise intensity ≥70 dB were recorded.

MAIN RESULTS

The maximum movement-evoked pain score was significantly lower in the intervention group than in the control group (mean score [SD], 2.7 [1.0] and 4.0[1.0], respectively; P < 0.001). The intervention group required significantly fewer opioids than the control group (mean [SD], 44.2 [12.8] and 51.3[17.5] mg, respectively; P = 0.032). In the control group, but not the intervention group, all postoperative pain scores were significantly associated with the proportion of intraoperative time with noise intensity ≥70 dB, which was an independent risk factor for postoperative pain.

CONCLUSION

During laparoscopic surgery under general anesthesia, intraoperative noise isolation using noise-cancelling headphones is a safe and effective strategy for relieving postoperative pain and decreasing total opioid analgesic consumption.

摘要

研究目的

大多数全身麻醉下的腹腔镜手术都是在嘈杂的环境中进行的,尽管术中降低噪音对术后疼痛的影响尚不确定。本研究旨在探讨术中使用降噪耳机是否可以减轻术后疼痛。

设计

这是一项前瞻性平行组随机临床试验。

地点

手术室和手术间。

患者

90 例全身麻醉下接受腹腔镜手术的患者。

干预措施

干预组在全身麻醉下进行腹腔镜手术时使用降噪耳机降低噪音强度。

测量

主要结果是术后 24 小时内最大运动诱发疼痛强度,使用 10 分制数字评分量表测量。次要结果包括术后 24 小时内最大静息疼痛评分和总阿片类药物消耗量。记录术中平均噪声和噪声强度≥70dB 的术中时间比例。

主要结果

干预组的最大运动诱发疼痛评分明显低于对照组(平均评分[标准差],2.7[1.0]和 4.0[1.0];P<0.001)。干预组所需的阿片类药物明显少于对照组(平均[标准差],44.2[12.8]和 51.3[17.5]mg,分别;P=0.032)。在对照组,但不是干预组,所有术后疼痛评分与术中噪声强度≥70dB 的时间比例显著相关,这是术后疼痛的独立危险因素。

结论

在全身麻醉下进行腹腔镜手术时,使用降噪耳机进行术中噪声隔离是一种安全有效的缓解术后疼痛和减少总阿片类药物镇痛消耗的策略。

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