Petričević Anja, Budrovac Dino, Lenz Ivana, Kvolik Slavica
Department of Anesthesiology, Resuscitation and Intensive Care, Osijek University Hospital, Osijek, J. Huttlera 4, Osijek, Croatia.
Medical faculty, Josip Juraj Strossmayer University, Osijek, Croatia.
Acta Clin Croat. 2023 Nov;62(Suppl4):5-11. doi: 10.20471/acc.2023.62.s4.1.
Suggestive preparation before surgery may have a placebo effect and can reduce perioperative consumption of analgesics. A total of 77 adult patients undergoing elective cholecystectomy and hernioplasty were included in this prospective study. All patients were given 100 mg of ketoprofen intravenously and were assigned to two groups. The first group was not informed about analgesia (no preparation, NP group), and the second group were told that they will receive a strong painkiller (suggestive preparation, SP group). Pulse rate, blood pressure and VAS scores were registered in all patients immediately before anesthesia induction in the operating room (T1), after waking up in the recovery room (T2), 6 hours after surgery at the surgical ward (T3) and on the morning after surgery in the surgical ward (T4), at rest and during movement. Rescue nonsteroidals were offered to patients with VAS 3-4, and opioids for VAS ≥5. The patients in the SP group had lower VAS scores in all measurements and lower opioid consumption. A statistically significant difference was observed in VAS2 measurement during movement (3 [2-5] vs. 2 [0-3.75] in the NP and SP group, P=0.008). SP had a placebo effect and reduced VAS scores as well as opioid consumption.
术前的暗示性准备可能具有安慰剂效应,并可减少围手术期镇痛药的用量。本前瞻性研究纳入了77例接受择期胆囊切除术和疝修补术的成年患者。所有患者均静脉注射100 mg酮洛芬,并分为两组。第一组未被告知镇痛相关事宜(无准备组,NP组),第二组被告知他们将接受一种强效止痛药(暗示性准备组,SP组)。在手术室麻醉诱导前(T1)、恢复室苏醒后(T2)、术后6小时在外科病房(T3)以及术后次日早晨在外科病房(T4),记录所有患者静息和活动时的心率、血压及视觉模拟评分(VAS)。VAS评分为3 - 4分的患者给予补救性非甾体类药物,VAS评分≥5分的患者给予阿片类药物。SP组患者在所有测量中的VAS评分均较低,阿片类药物用量也较少。在活动时的VAS2测量中观察到统计学显著差异(NP组为3 [2 - 5],SP组为2 [0 - 3.75],P = 0.008)。暗示性准备具有安慰剂效应,可降低VAS评分及阿片类药物用量。