- 期刊
The Preemptive Effect of Pre-incisional Bupivacaine Infiltration on Postoperative Analgesia Following Lower Abdominal Surgery under Epidural Anesthesia
術前傷口浸潤Bupivacaine對下腹部手術接受硬脊膜外腔麻醉之術後止痛作用
摘要
Background: In attempts to reduce central sensitization after tissue injury, the concept of preemptive analgesia has evolved. The aim of the present study was to evaluate the preemptive effect of pre-incisional infiltration of the surgical area with bupivacaine on pain following lower abdominal surgery under epidural anesthesia. Methods: Sixty female patients scheduled for lower abdominal surgery under epidural anesthesia with bupivacaine were randomly divided into two Groups (n = 30, each). Five minutes before surgical incision, patients in Group 1 received subcutaneous infiltration of the proposed surgical area with 30 ml of 0.125% bupivacaine (with 1/200,000 epinephrine), while those in Group 2 received 30 ml of isotonic saline (with 1/200,000 epinephrine) infiltration. Postoperatively, pain was assessed for 48 h by a visual analogue scale of pain at rest, during cough and by cumulative morphine doses (self-administered by patient-controlled analgesia). Results: The pain score at rest was significantly lower in Group 1 than in Group 2 from the 6th h to the 24th h postoperatively. The cough-associated pain score was lower in Group 1 than in Group 2 from the 6th h to the 28th h postoperatively. Furthermore, Group 1 consumed less morphine than did Group 2 from the 6th h to the 24th h postoperatively. Conclusions: The results indicate that pre-incisional infiltration of surgical area with bupivacaine markedly decreases the intensity of pain following lower abdominal surgery under epidural anesthesia.
並列摘要
背景：前瞻性止痛法已被使用來預防組織受損後所產生的中樞神經致敏化。本研究的目的在於探討接受硬腦膜外麻醉施行下腹部手術之病患加以局部浸潤性麻醉對於手術後疼痛之影響。方法：共60位接受硬腦膜外麻醉之下腹部手術之女性患者依隨機分為2組（每組30人）。在劃刀前，第一組病患接受下刀部位旁皮下注射30毫升的0.125% bupivacaine，（加1:20萬濃度epinephrine），而第二組接受30毫升的生理鹽水（加1:20萬濃度epinephrine）皮下注射。手術後觀察48小時，並記錄休息時及咳嗽後之疼痛分數及記錄累積嗎啡需要量（經由病患控制給藥裝置）。結果：在手術後6－24小時間，第一組在休息時之疼痛分數較低，並且在6－28小時間，第一組在咳嗽後之疼痛分數也較低。同時第一組額外需求嗎啡的量也較少。結論：本研究結果顯示接受硬腦膜外麻醉施行下腹部手術之病患加以局部浸潤性麻醉對於手術後疼痛有預防作用。
延伸閱讀
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