Vallerand W P, Vallerand A H, Heft M
Department of Oral/Maxillofacial Surgery, University of Medicine and Dentistry of New Jersey, Newark 07103-2400.
J Oral Maxillofac Surg. 1994 Nov;52(11):1165-70; discussion 1170-1. doi: 10.1016/0278-2391(94)90536-3.
Previous studies have shown that perioperative patient education providing coping strategies and/or reasonable expectations regarding the postoperative course can help lessen patient anxiety and decrease pain, complications, and recovery time. This study investigated these effects following extraction of third molars.
Forty patients scheduled to undergo surgical extraction under local anesthetic and intravenous conscious sedation were randomly assigned to one of two groups. Treatment group members were given postoperative instructions that included descriptive information regarding potential sequelae (eg, pain, edema, trismus, nausea) as well as detailed information regarding analgesic use. Control group members were given basic open-ended postoperative wound care instructions. Postoperative pain and satisfaction with pain control were recorded using visual analogue scales. Analgesic consumption was also recorded. Thirty-seven patients completed the protocol.
Patients in the treatment group reported significantly less pain during the period from 12 to 18 hours, and at 24 hours postoperatively, but there was no significant difference in analgesic consumption between groups. Patient satisfaction with pain control was significantly greater in the treatment group.
These results indicate that increasing the quantity of postoperative preparatory information significantly increases pain relief and resultant satisfaction with pain control without increasing analgesic consumption.
先前的研究表明，围手术期对患者进行教育，提供应对策略和/或对术后过程的合理预期，有助于减轻患者焦虑，减少疼痛、并发症并缩短恢复时间。本研究调查了拔除第三磨牙后的这些影响。
40例计划在局部麻醉和静脉清醒镇静下接受手术拔除的患者被随机分为两组。治疗组患者接受术后指导，包括关于潜在后遗症（如疼痛、水肿、牙关紧闭、恶心）的描述性信息以及关于镇痛药物使用的详细信息。对照组患者接受基本的开放式术后伤口护理指导。使用视觉模拟量表记录术后疼痛及对疼痛控制的满意度。同时记录镇痛药物的消耗量。37例患者完成了该方案。
治疗组患者在术后12至18小时以及术后24小时报告的疼痛明显减轻，但两组之间的镇痛药物消耗量无显著差异。治疗组患者对疼痛控制的满意度明显更高。
这些结果表明，增加术后准备信息的数量可显著提高疼痛缓解程度以及由此产生的对疼痛控制的满意度，而不会增加镇痛药物的消耗量。
