Randomized Controlled Trial in Postoperative Pain Between Plasma Knife-assisted Versus Traditional Uvulopalatopharyngoplasty in Sleep-disordered Breathing Patients

以隨機臨床試驗比較電漿刀輔助與傳統懸壅垂腭咽成形術之術後疼痛

郭子龍(Tzu-Lung Kuo) ； 江榮山(Rong-San Jiang) ； 黃于嘉(Yu-Chia Huang) ； 劉時安(Shih-An Liu)

《台灣耳鼻喉頭頸外科雜誌》 50卷2期 (2015/06) Pp. 82-89

https://doi.org/10.6286/2015.50.2.82

摘要

背景：本研究乃比較睡眠呼吸障礙患者接受電漿刀輔助及傳統懸壅垂腭咽成形術術後疼痛之差異。方法：本研究採前瞻性隨機臨床分配設計，納入條件：年滿20歲因睡眠呼吸障礙欲接受懸壅垂腭咽成形術者，排除曾接受軟顎手術、凝血功能障礙、長期服用止痛藥、或不願加入研究者，取得受試者同意書後，以電腦亂數隨機分配為二組，實驗組接受電漿刀輔助懸壅垂腭咽成形術，控制組則接受傳統術式，收集基本資料、睡眠檢查結果、理學檢查、睡眠呼吸障礙相關問卷、術後疼痛程度、及術後止痛藥使用量，來進行統計分析。結果：總共有19名患者進入最後之統計分析，9名為實驗組，10名為控制組。年齡、性別、睡眠檢查結果、嗜睡指數、及術後主觀疼痛程度在兩組間並無明顯統計學上的差異。但在客觀之止痛藥使用量方面，實驗組服用之止痛藥較控制組來得少，而在術後飲食方面，實驗組也較快恢復正常飲食。結論：以電漿刀輔助之懸壅垂腭咽成形術，能減少患者術後止痛藥之使用量，也讓患者較快回復正常飲食。

關鍵字

電漿刀 ； 睡眠呼吸障礙 ； 懸壅垂腭咽成形 ； 術後疼痛

並列摘要

BACKGROUND: We aimed to compare postoperative pain between plasma knife-assisted and traditional uvulopalatopharyngoplasty (UPPP) in sleep-disordered breathing patients. METHODS: This was a prospective randomized controlled study. Patients who were scheduled to undergo UPPP was eligible this study. Those who had previous palatal operations due to sleep-disordered breathing, had coagulation disorder, were under long-term non-steroidal anti-inflammatory drugs therapy, or were reluctant to participate were excluded. All patients signed inform consents. Patients were then randomly assigned to receive plasma knife-assisted (study group) or traditional UPPP (control group). Basic demographic data along with polysomnography results, operation-related variables, postoperative pain, analgesic usage, and diet intake status were collected and analyzed. RESULTS: A total of 19 patients were included in the final analyses, with 9 patients in the study group and 10 patients in the control group. No significant differences were found between the two groups in age, gender, polysomnography results, peri-operative bleeding, hospitalization duration, postoperative pain status. However, the study group had shorter operation duration and a lower amount of analgesics usage. In addition, the study group also returned to normal diet earlier. CONCLUSIONS: The use of plasma knife shortened the operation duration and reduced the amount of analgesics needed after UPPP.

並列關鍵字

plasma knife ； sleep-disordered breathing ； uvulopalatopharyngoplasty ； postoperative pain