Clin Translational Gastroenterology: 肛肠手术后镇痛药物的疗效比较

2019-02-16 不详 MedSci原创

本研究的目的是评估利多卡因联合双氯芬酸方案(CLIFE1)的局部镇痛效果与利多卡因(CLIFE2)单药方案相比的疗效和安全性,做此项研究的目的主要为了更好地减少良性肛门直肠手术(BARS)患者的疼痛。因为超过50%接受BARS的患者患有中度和重度术后疼痛。

目的: 
本研究的目的是评估利多卡因联合双氯芬酸方案(CLIFE1)的局部镇痛效果与利多卡因(CLIFE2)单药方案相比的疗效和安全性,做此项研究的目的主要为了更好地减少良性肛门直肠手术(BARS)患者的疼痛。因为超过50%接受BARS的患者患有中度和重度术后疼痛。

方法: 
研究人员在西班牙的两家医疗中心进行了一项多中心,随机双盲的对照试验。接受BARS(痔疮,肛瘘和肛裂)的患者在手术结束时以1:1的比例随机接受CLIFE1方案镇痛(n = 60)或CLIFE2方案镇痛(n = 60),主要镇痛时间为术后前三天每12小时一次,第四至第六天为每天一次。主要结果是局部治疗后疼痛减少的平均值,这由患者自己用视觉模拟评分(VAS)进行测量。

结果: 
结果显示在150例接受BARS治疗的患者中,CLIFE1方案局部镇痛的效果要好于CLIFE2方案(7.47±13.04 VS. 4.38±6.75, p = 0.008), CLIFE1方案中35%接受良性肛肠手术的患者术后疼痛(≥9mm,VAS)明显减少,而利多卡因单药治疗的患者为18.33%。

结论:  
CLIFE1方案局部镇痛治疗在BARS中的疗效更好。

原始出处:

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    2020-01-17 bsmagic9140
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    2019-03-21 许安
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  5. 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  8. 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2019, time=2019-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1795878, encodeId=db201e9587800, content=<a href='/topic/show?id=42211e757d7' target=_blank style='color:#2F92EE;'>#Translation#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17757, encryptionId=42211e757d7, topicName=Translation)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eqPdWFricgmt6Dde2ptNxJzD6Y9c4cxpXdTo4pNlVPARAnFdKu6nWIPele9icxApTaFgibq0uVlgRiceQ/132, createdBy=4b8c2500026, createdName=ms8435843352634314, createdTime=Sat Jul 13 12:33:00 CST 2019, time=2019-07-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1355305, encodeId=68eb135530536, content=<a href='/topic/show?id=256a96e9990' target=_blank style='color:#2F92EE;'>#镇痛#</a>, beContent=null, objectType=article, channel=null, level=null, 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    2019-02-18 zhaojie88
  10. 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有超过50%良性肛门直肠手术(BARS)的患者,特别是痔切除术,会有中度和重度术后疼痛,本研究的目的是评估含有利多卡因加双氯芬酸(CLIFE1)的局部制剂与利多卡因(CLIFE2)相比是否可以增加止痛效果,并进行安全性评估。

DCR:肛肠手术预先镇痛安全有效!

术后疼痛是门诊手术后延迟出院的常见原因,这些常规手术常包括肛肠手术。中枢和外周疼痛受体致敏都被认为是导致术后疼痛的主要原因。阻断这些受体的预先致敏可预防痛觉过敏,从而降低疼痛药物的需求。骨科,泌尿科和妇科文献的研究均支持这种做法,但在肛肠手术中使用预先性镇痛治疗尚未得到充分研究。本研究旨在评估预先镇痛在减少术后疼痛方面的有效性。