Soni Ankit, Singh Brijesh P, Srivastava Vinod K, Prakash Ravi, Gautam Shefali, Singh Gyan Prakash
Anaesthesiology, King George's Medical University, Lucknow, IND.
Cureus. 2024 Dec 17;16(12):e75877. doi: 10.7759/cureus.75877. eCollection 2024 Dec.
BACKGROUND: The primary objective of this study was to compare the efficacy of lignocaine-dexamethasone and lignocaine-triamcinolone infiltration, along the spinal-epidural needle insertion pathway, to prevent backache after lower abdominal surgeries. METHODS: This prospective, double-blind randomized controlled study included a total of 150 patients, scheduled for elective lower abdominal surgery under combined spinal-epidural (CSE) anaesthesia. The patients were randomised into three groups Group L (Lignocaine, n=50), Group DL (Dexamethasone, Lignocaine, n=50), and Group TL (Triamcinolone, Lignocaine, n=50). RESULTS: The Visual Analogue Score (VAS) was used to assess the postoperative pain. The anthropometric and demographic findings were comparable among the three groups. The mean VAS score at the time points of needle placement and at postoperative time periods of 24 hours, 48 hours, 72 hours, one month, two months and three months were significantly lower (p<0.001) in groups DL and TL compared to group L. CONCLUSION: This study demonstrated that the addition of a steroid like triamcinolone or dexamethasone with lignocaine for local infiltration along the spinal-epidural tract significantly lowers the severity of post-needle puncture backache in comparison to lignocaine alone in lower abdominal surgeries.
背景:本研究的主要目的是比较利多卡因-地塞米松和利多卡因-曲安奈德沿腰麻-硬膜外穿刺针进针路径进行浸润,预防下腹部手术后背痛的效果。 方法:这项前瞻性、双盲随机对照研究共纳入150例计划在腰麻-硬膜外联合麻醉下行择期下腹部手术的患者。患者被随机分为三组:L组(利多卡因,n = 50)、DL组(地塞米松、利多卡因,n = 50)和TL组(曲安奈德、利多卡因,n = 50)。 结果:采用视觉模拟评分法(VAS)评估术后疼痛。三组患者的人体测量学和人口统计学结果具有可比性。与L组相比,DL组和TL组在穿刺时以及术后24小时、48小时、72小时、1个月、2个月和3个月时的平均VAS评分显著降低(p < 0.001)。 结论:本研究表明,在下腹部手术中,与单独使用利多卡因相比,在利多卡因中添加曲安奈德或地塞米松等类固醇进行腰麻-硬膜外穿刺路径局部浸润,可显著降低穿刺后背痛的严重程度。
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