Hannibal K, Galatius H, Hansen A, Obel E, Ejlersen E
Department of Surgery and Anesthesiology, Sygehuset Oresund, Denmark.
Anesth Analg. 1996 Aug;83(2):376-81. doi: 10.1097/00000539-199608000-00030.
We conducted a randomized, double-blind trial to evaluate the early and late analgesic effect of preoperative wound infiltration with bupivacaine 0.25% (40 mL) compared to placebo (NaCl 0.9%, 40 mL) in patients undergoing major surgery. Forty-one patients scheduled for elective hysterectomy during general anesthesia were included. The pain management focused on pain prevention, including preoperative administration of nonsteroidal antiinflammatory drugs (NSAIDs), and peroperative administration of opioids. Postoperatively patients received buprenorphine and/or acetaminophen on demand. A significant difference between treatments was evident in the 3-day postoperative trial period. With identical pain scores in the two groups, the requested total amount of buprenorphine was greater in the placebo group (2.0 [0-5.1] mg) (median and [range]) than in the bupivacaine group (0.8 [0-2.8] mg) (P < 0.05). The demand for analgesics occurred earlier in those who received placebo (225 min) than in those who received bupivacaine (345 min), but did not reach the level of significance. In conclusion, preoperative wound infiltration with bupivacaine improved immediate and late postoperative pain management after hysterectomy compared to placebo.
我们进行了一项随机双盲试验，以评估在接受大手术的患者中，术前伤口浸润0.25%布比卡因（40毫升）与安慰剂（0.9%氯化钠，40毫升）相比的早期和晚期镇痛效果。纳入了41例计划在全身麻醉下进行择期子宫切除术的患者。疼痛管理侧重于疼痛预防，包括术前给予非甾体抗炎药（NSAIDs）和术中给予阿片类药物。术后患者按需接受丁丙诺啡和/或对乙酰氨基酚。在术后3天的试验期内，治疗组之间存在显著差异。两组疼痛评分相同，但安慰剂组（2.0[0 - 5.1]毫克）（中位数和[范围]）所需丁丙诺啡总量高于布比卡因组（0.8[0 - 2.8]毫克）（P < 0.05）。接受安慰剂的患者（225分钟）比接受布比卡因的患者（345分钟）更早出现镇痛需求，但未达到显著水平。总之，与安慰剂相比，术前伤口浸润布比卡因改善了子宫切除术后的即时和晚期术后疼痛管理。
