Clin Oral Investig:正颌手术中静脉注射布洛芬可有效缓解患者术后疼痛

2022-06-10 sunshine MedSci原创

正颌手术是颌面外科的一个标准程序,但是术后剧烈疼痛并不少见,需要有效的干预措施。

正颌手术是颌面外科的一个标准程序,但是术后剧烈疼痛并不少见,需要有效的干预措施。近日,发表于Clin Oral Investig的一项前瞻性、随机、双盲、对照的临床研究评估了布洛芬与双氯芬酸加奥芬那定对正颌手术术后疼痛的镇痛效果。

研究纳入将接受正颌手术的患者,随机分为两组:静脉注射600毫克布洛芬(I组)或75毫克双氯芬酸加30毫克奥芬那定(D组),两组都是每天两次。此外,两组都给予甲硝唑500毫克。抢救性止痛药包括对乙酰氨基酚1000毫克和皮利曲胺7.5毫克,视需要而定。主要终点是在住院期间每天三次记录的数字评分表(NRS)以评估疼痛强度,为期3天。

结果,2019年5月至2020年11月,共入组109名患者(年龄范围,18至61岁),进行了48例双侧矢状劈开截骨术(BSSO)和51例双侧颌骨截骨术(BIMAX)。手术亚组分析发现,与I组相比,BIMAX D组患者术后第三天的平均NRS明显较高(2.73 vs.1.23)(P = 0.015)。此外,随着患者身体质量指数(BMI)的增加,平均NRS(r = 0.517,p = 0.001)也增加。在年龄、性别、住院时间、体重、手术时间、疼痛完全缓解的患者数量、对乙酰氨基酚或皮硝唑摄入量和NRS值之间没有发现差异。此外,试验期间也没有观察到不良事件。

综上所述,该研究结果表明,布洛芬的使用和较低的BMI与术后第三天接受双侧颌骨截骨术的患者疼痛较少有关。因此,外科医生可以选择布洛芬,以便在正颌手术后更有效地缓解患者的疼痛。

原始出处: 

Josip Tomic, et al., Intravenous ibuprofen versus diclofenac plus orphenadrine in orthognathic surgery: a prospective, randomized, double-blind, controlled clinical study. Clin Oral Investig. 2022 May;26(5):4117-4125. doi: 10.1007/s00784-022-04381-5.

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    2022-12-28 fusion
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    2022-07-11 小几洁
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