评估术中皮下注射麻醉剂对甲状腺全切除术患者疼痛管理的效果。
Evaluation of intraoperative subcutaneous anesthetic infiltration for pain management in patients undergoing total thyroidectomy.
作者信息
Carlesse Phamella, Cardoso Nathalia, Harati Tamara, Lapichini Bruna, Partezani Daniel Herman, de Matos Leandro Luongo, Dedivitis Rogério Aparecido
机构信息
Universidade Metropolitana de Santos, Santos, SP, Brazil.
Irmandade Santa Casa de Santos, Departamento de Cirurgia de Cabeça e Pescoço, Santos, SP, Brazil.
出版信息
Braz J Otorhinolaryngol. 2025 Jul;91 Suppl 1(Suppl 1):101613. doi: 10.1016/j.bjorl.2025.101613. Epub 2025 May 27.
OBJECTIVE
To evaluate the efficacy of intraoperative Bupivacaine application in reducing postoperative pain among patients undergoing total thyroidectomy.
METHODS
A prospective study was carried out with 153 female patients undergoing total thyroidectomy, with a randomization protocol for topical anesthetic infiltration. Postoperative pain intensity was self-reported by the patients using the Visual Analog Scale (VAS) at the 1st, 6th, and 24th postoperative hours.
RESULTS
Comparative analysis revealed that patients who did not receive anesthetic infiltration experienced, on average, higher pain levels during all three observation periods (1st and 6th hours, and 24th hour; p = 0.0001 - repeated measures ANOVA multiple test) relative to those who received the anesthetic. Isolated observations showed that pain was significantly less severe at the 24th hour compared to the 6th hour (p = 0.001 - repeated measures ANOVA test).
CONCLUSION
Topical anesthetic infiltration proves to be an effective tool for managing post-thyroidectomy pain.
LEVEL OF EVIDENCE
Level III.
目的
评估术中应用布比卡因对甲状腺全切除术后患者疼痛的缓解效果。
方法
对153例行甲状腺全切除术的女性患者进行前瞻性研究，采用随机方案进行局部麻醉浸润。术后疼痛强度由患者在术后第1、6和24小时使用视觉模拟量表（VAS）自行报告。
结果
对比分析显示，在所有三个观察期（第1和6小时以及第24小时；p = 0.0001 - 重复测量方差分析多重检验），未接受麻醉浸润的患者平均疼痛程度高于接受麻醉的患者。单独观察显示，与第6小时相比，第24小时的疼痛明显减轻（p = 0.001 - 重复测量方差分析检验）。
结论
局部麻醉浸润被证明是管理甲状腺切除术后疼痛的有效手段。
证据级别
三级。
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