术中硬膜外给药左布比卡因对腰椎间盘手术术后疼痛的影响

Serpil Çetin Gül, Ayşe Yılmaz, Zeynep Balaban, Özgür Yılmaz, D. Yörükoğlu
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引用次数: 0

摘要

目的:术后疼痛是影响外科病例发病率的重要问题。我们的目标是通过使用我们选择的药物和方法来提供术后镇痛,以最小的副作用提供最大的益处,促进恢复期,加速活动,并为患者提供安全和舒适。材料和方法:我们的研究包括60例择期或紧急腰椎间盘手术。患者随机分为两组;(a) S组;全麻及术中硬膜外生理盐水注射组;(b) L组;患者行全身麻醉,术中硬膜外注射左布比卡因2.5 mg/mL。围手术期监测患者血流动力学参数。对所有患者,在必要的情况下,给予静脉吗啡患者自控镇痛。疼痛评估采用数值疼痛评定量表和视觉模拟量表。此外,还评估了24小时内吗啡的使用情况、疼痛评分、活动时间、患者满意度和副作用。结果:左旋布比卡因组在整个试验过程中疼痛评分较低,24小时内吗啡用量较低,首次活动时间较短,患者满意度较显著,且考虑到副作用,该组更具有临床意义。结论:硬膜外bupivacaine结合静脉吗啡的使用而不是单独静脉吗啡术后镇痛更有利于早期动员、减少并发症,和更好的病人满意度
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The effect of intraoperative epidural levobupivacaine administration in lumbar disc surgery for postoperative pain
Aim: Postoperative pain is an essential problem that affects morbidity in surgical cases. We aimed to provide maximal benefits with minimal side effects, facilitate the recovery period, accelerate mobilization, and provide patient safety and comfort through the usage of the drug and method of our choice to provide postoperative analgesia.Material and Method: Our study included 60 elective or urgent lumbar disc surgery cases. The patients were randomly divided into two groups; (a) The Group S; patients receiving general anesthesia and intraoperative epidural saline injection, and (b) The Group L; patients receiving general anesthesia and intraoperative epidural 2.5 mg/mL levobupivacaine 10 mL injection. The patient’s hemodynamic parameters were monitored perioperatively. To all patients, in case of necessity, patient-controlled analgesia with IV morphine was administered. The pain assessment was done using a numeric pain rating scale and visual analog scale. In addition, morphine usage during the 24 hours, pain scores, mobilization time, patient satisfaction, and side effects were evaluated.Results: In the levobupivacaine group, the pain scores were lower during the whole trial, the morphine consumption in the 24 hour period was lower, the first time of mobilization was shorter, the patient satisfaction was more remarkable, and this group was more clinically significant considering side effects.Conclusion: The usage of epidural bupivacaine combined with IV morphine instead of IV morphine alone for postoperative analgesia is more beneficial for early mobilization, reducing complications, and better patient satisfaction
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