Forgach L, Ong B Y
Department of Anaesthesia, University of Manitoba, Winnipeg, Canada.
Can J Anaesth. 1995 Dec;42(12):1085-9. doi: 10.1007/BF03015093.
Many women experience considerable pain and delay in return to regular activity after laparoscopic tubal ligation. We performed a prospective randomized double-blind study to evaluate pain and recovery after laparoscopic tubal ligation and the influence of meperidine wound infiltration. After approval by the Ethics Committee, informed consent was obtained from 60 patients. All patients received naproxen 500 mg po one hour before surgery. Patients were randomized into three groups. All patients received a standard general anaesthetic. Group C patients (n = 18) received normal saline (NS) in the deltoid and NS in the wound. Group S patients (n = 21) received 50 mg of meperidine in the deltoid and NS in the wound. Group W patients (n = 21) received 50 mg meperidine in the wound and NS in the deltoid. After surgery, pain and nausea were treated with morphine and metoclopramide as needed. Following hospital discharge, patients were contacted by telephone daily until they returned to regular activities. The mean maximum pain score of Group S patients was lower than that of Group C patients (P < 0.05). Group S patients required less morphine in the Postanaesthesia Care Unit than the Group C patients (P < 0.05). One Group C patient was readmitted to hospital due to inadequate analgesia with oral medications. Group S patients returned to regular activity earlier than the Group C patients (P < 0.05). It is concluded that wound infiltration with meperidine did not affect postoperative pain or recovery. Intramuscular administration of the same amount of meperidine resulted in less postoperative pain and earlier return to regular activity.
许多女性在腹腔镜输卵管结扎术后会经历相当程度的疼痛,且恢复正常活动的时间会延迟。我们进行了一项前瞻性随机双盲研究,以评估腹腔镜输卵管结扎术后的疼痛与恢复情况以及哌替啶伤口浸润的影响。经伦理委员会批准后,我们获得了60名患者的知情同意。所有患者在手术前1小时口服500毫克萘普生。患者被随机分为三组。所有患者均接受标准全身麻醉。C组患者(n = 18)在三角肌处注射生理盐水(NS),伤口处也注射NS。S组患者(n = 21)在三角肌处注射50毫克哌替啶,伤口处注射NS。W组患者(n = 21)在伤口处注射50毫克哌替啶,三角肌处注射NS。术后,根据需要用吗啡和甲氧氯普胺治疗疼痛和恶心。出院后,每天通过电话联系患者,直到他们恢复正常活动。S组患者的平均最大疼痛评分低于C组患者(P < 0.05)。S组患者在麻醉后护理单元所需的吗啡量比C组患者少(P < 0.05)。一名C组患者因口服药物镇痛不足而再次入院。S组患者比C组患者更早恢复正常活动(P < 0.05)。得出的结论是,哌替啶伤口浸润并不影响术后疼痛或恢复。肌肉注射相同剂量的哌替啶可减轻术后疼痛,并使患者更早恢复正常活动。