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双氯芬酸钠与硫酸吗啡用于日间腹股沟疝修补术后镇痛的比较。

Comparison of diclofenac sodium and morphine sulphate for postoperative analgesia after day case inguinal hernia surgery.

作者信息

McEvoy A, Livingstone J I, Cahill C J

机构信息

Department of Surgery, Kingston Hospital NHS Trust, Kingston upon Thames, Surrey.

出版信息

Ann R Coll Surg Engl. 1996 Jul;78(4):363-6.

Abstract

Postoperative pain may be a significant reason for delayed discharge from hospital, increased morbidity and reduced patient satisfaction with ambulatory hernia surgery. This study compared two postoperative oral analgesic protocols after day case inguinal hernia repair; 30 mg morphine sulphate (MST) and 10 mg metoclopramide every 8 h for 48 h or 75 mg diclofenac twice daily for 48 h. The pain reported in the MST group was significantly greater on both the day of operation and the first postoperative day (P < 0.05, Mann-Whitney U test). A significantly higher proportion of patients taking MST complained of nausea on the day of operation and on the 1st postoperative day (P < 0.05, chi 2). The time taken to walk, dress and leave home alone were achieved in a significantly shorter duration in patients taking diclofenac. We conclude that diclofenac provides effective analgesia, has a more acceptable side-effect profile than morphine sulphate and is the treatment of choice after ambulatory hernia surgery.

摘要

术后疼痛可能是导致患者延迟出院、发病率增加以及门诊疝修补术后患者满意度降低的重要原因。本研究比较了日间腹股沟疝修补术后两种口服镇痛方案;每8小时服用30毫克硫酸吗啡(MST)和10毫克甲氧氯普胺,共48小时,或每日两次服用75毫克双氯芬酸,共48小时。MST组在手术当天和术后第一天报告的疼痛明显更严重(P < 0.05,曼-惠特尼U检验)。服用MST的患者在手术当天和术后第1天抱怨恶心的比例明显更高(P < 0.05,卡方检验)。服用双氯芬酸的患者独自行走、穿衣和离开家所需的时间明显更短。我们得出结论,双氯芬酸提供有效的镇痛效果,副作用比硫酸吗啡更易接受,是门诊疝修补术后的首选治疗方法。

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本文引用的文献

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Pre-emptive analgesia.超前镇痛
BMJ. 1993 Jan 30;306(6873):285-6. doi: 10.1136/bmj.306.6873.285.
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Br J Surg. 1993 Jun;80(6):745-6. doi: 10.1002/bjs.1800800629.
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The prevention of postoperative pain.术后疼痛的预防
Pain. 1988 Jun;33(3):289-290. doi: 10.1016/0304-3959(88)90286-2.
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Ambulatory hernia surgery.门诊疝修补手术
Br J Surg. 1989 Dec;76(12):1228-9. doi: 10.1002/bjs.1800761203.
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Postoperative nefopam and diclofenac. Evaluation of their morphine-sparing effect after upper abdominal surgery.
Anaesthesia. 1990 Apr;45(4):302-5. doi: 10.1111/j.1365-2044.1990.tb14737.x.

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