Salimi Sohrab, Taheri Mehrdad, Khayat Kashani Hamid Reza, Ghani Farnazsadat, Behnaz Faranak, Ghasemi Mahshid
Department of Anesthesiology, Anesthesiology Research Center, Imam Hossein Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Anesthesiology, Imam Hossein Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Anesth Pain Med. 2023 Nov 6;13(5):e139758. doi: 10.5812/aapm-139758. eCollection 2023 Oct.
The pain experienced following supratentorial brain surgery is usually defined as moderate to severe. Therefore, pain-management approaches, including narcotics, are an integral part of treatment regimens that cause respiratory complications or seizures, and reducing this pain level and increasing patient satisfaction is vital.
This randomized, double-blind clinical trial study to evaluate the pain level and satisfaction in patients undergoing surgery for supratentorial brain neoplasms was performed on two groups with a sample size of 50 patients. In group I, after removal of the brain lesion (at the beginning of dura closure), 400 mg of ibuprofen solution was infused intravenously over 30 minutes. In group II, morphine 0.07 mg/kg intravenously with 1000 mg paracetamol was infused over 30 minutes. After injecting ibuprofen and paracetamol morphine, the patient's pain level and satisfaction with the process were checked.
Patients' satisfaction score in the first 6 hours in the ibuprofen group was 1.67 ± 0.72, and in the other group was 2.27 ± 0.7, which was statistically different (P-value = 0.029). The mean of VAS in the first, second, third, and fourth hours was not statistically different. In the comparative analysis of the laboratory indicators of platelet function analysis in the two groups, none of the measured items had a significant difference between the two groups in the three measurement periods (P > 0.05).
Administration of ibuprofen led to pain relief and patient satisfaction comparable to morphine and paracetamol, and after the surgery for supratentorial brain tumors, ibuprofen did not affect the patients' blood clotting functions.
幕上脑手术后经历的疼痛通常被定义为中度至重度。因此，包括麻醉药品在内的疼痛管理方法是治疗方案中不可或缺的一部分，这些方法会引发呼吸并发症或癫痫发作，降低这种疼痛程度并提高患者满意度至关重要。
这项随机、双盲临床试验旨在评估幕上脑肿瘤手术患者的疼痛程度和满意度，研究对象分为两组，每组50例患者。在第一组中，脑病变切除后（硬脑膜关闭开始时），在30分钟内静脉输注400毫克布洛芬溶液。在第二组中，静脉注射0.07毫克/千克吗啡并同时输注1000毫克对乙酰氨基酚，输注时间为30分钟。注射布洛芬和对乙酰氨基酚吗啡后，检查患者的疼痛程度和对该过程的满意度。
布洛芬组患者在前6小时的满意度评分为1.67±0.72，另一组为2.27±0.7，差异具有统计学意义（P值=0.029）。第一、第二、第三和第四小时的视觉模拟评分法（VAS）平均值无统计学差异。在两组血小板功能分析实验室指标的比较分析中，三个测量时间段内两组的所有测量项目均无显著差异（P>0.05）。
布洛芬的给药导致的疼痛缓解和患者满意度与吗啡和对乙酰氨基酚相当，并且在幕上脑肿瘤手术后，布洛芬不影响患者的凝血功能。
