Nehra D, Gemmell L, Pye J K
Department of Surgery, Maelor General Hospital, Wrexham, UK.
Br J Surg. 1995 Sep;82(9):1245-7. doi: 10.1002/bjs.1800820929.
A randomized double-blind study was undertaken using 0.5 per cent bupivacaine ilioinguinal field block and oral papaveretum-aspirin tablets to assess pain relief after hernia surgery. A consecutive series of 200 men undergoing repair of a unilateral inguinal hernia underwent random allocation into one of the four groups to receive: bupivacaine and papaveretum-aspirin (group 1), bupivacaine and oral placebo (group 2), saline and papaveretum-aspirin (group 3), or saline and oral placebo (group 4). Patients were prescribed postoperative opiates to be given on demand. Pain levels and mobility were assessed at 6 and 24 h after operation. Patients in group 1 reported significantly less pain, required less additional opiates and had better mobility than those in group 4 (pain score P < 0.001 at 6 h and P = 0.002 at 24 h) and group 3 (P = 0.002 for pain and mobility scores at 6 h). Bupivacaine alone provided good immediate postoperative pain relief (P = 0.002 group 2 versus group 4 at 6 h). The combination of bupivacaine and papaveretum-aspirin provided the best results and is suitable for day-case postoperative analgesia.
一项随机双盲研究采用0.5%布比卡因髂腹股沟区域阻滞联合口服罂粟碱 - 阿司匹林片来评估疝修补术后的疼痛缓解情况。连续200例接受单侧腹股沟疝修补术的男性被随机分配到四组之一,接受以下治疗:布比卡因和罂粟碱 - 阿司匹林(第1组)、布比卡因和口服安慰剂(第2组)、生理盐水和罂粟碱 - 阿司匹林(第3组)或生理盐水和口服安慰剂(第4组)。术后按需给患者开阿片类药物。在术后6小时和24小时评估疼痛程度和活动能力。第1组患者报告的疼痛明显少于第4组(术后6小时疼痛评分P < 0.001,24小时P = 0.002)和第3组(术后6小时疼痛和活动能力评分P = 0.002),所需额外阿片类药物更少,活动能力更好。单独使用布比卡因能提供良好的术后即时疼痛缓解(术后6小时第2组与第4组相比P = 0.002)。布比卡因和罂粟碱 - 阿司匹林联合使用效果最佳,适用于日间手术术后镇痛。