超声引导下髂腹股沟及髂腹下神经阻滞5%利多卡因贴片治疗腹股沟疝修补术后慢性疼痛的评价

Aliaa Faiter, Magdy Abd Mansour, A. Hozien
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引用次数: 0

摘要

目的评价超声引导下(IIN / IHN)阻滞或联合利多卡因(5%)贴片先发制人镇痛对急性、慢性疝修补术后疼痛(US)的疗效及患者满意度。患者和方法对60例全麻单侧腹股沟疝手术患者(平均分为两组)、30例未使用利多卡因(5%)贴片的患者(I组)和30例使用利多卡因(5%)贴片的患者(II组)进行先发制人的US引导IIN / IHN阻滞。比较两组患者满意度、术后疼痛强度、缝合后慢性疼痛及其对日常活动的影响。结果两组患者在4个问题中双神经症得分均有显著性差异,其中ⅰ组较高,P值< 0.001。组患者术后1、3、6个月的短期疼痛量表评分显著升高,P值为0.033。另一方面,各组术后1、3、6个月的短期疼痛量表(short Pain Inventory)差异无统计学意义,P值分别为0.378、0.931、0.934。两组患者满意度和术后视觉模拟量表差异不显著。结论超声引导下IIN / IHN阻滞可有效控制腹股沟疝修补术围术期疼痛。添加利多卡因(5%)贴片可提高患者满意度,改善术后慢性疼痛结局。
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Evaluation of chronic post-inguinal herniorrhaphy pain in patients receiving ultrasound-guided ilioinguinal and iliohypogastric nerve block with lidocaine (5%) patch
Aim To assess the efficacy of preemptive analgesia in the form of ultrasound-guided (IIN / IHN) block alone or with lidocaine (5%) patch on (US) acute, chronic post-herniorrhaphy pain and patient satisfaction. Patients and methods Preemptive US guided IIN / IHN block was performed on 60 patients (equally distributed into two groups) planned to undergo unilateral inguinal hernia operation under general anesthesia, 30 patients without lidocaine (5%) patch (group I) and 30 patients with lidocaine (5%) patch in the postoperative day 0 (group II). The groups were compared regarding patient satisfaction, intensity of postoperative pain, chronic post-herniorrhaphy pain, and its impact on daily activities. Results There were considerable differences between two groups as regards Douleur Neuropathique en 4 questions as it was higher in group I, P value less than 0.001. There was a significant increase in Brief Pain Inventory short form score postoperatively through 1, 3, and 6 months in group I, P value of 0.033. On the other hand, there were insignificant differences within each group as regards Brief Pain Inventory at 1, 3, and 6 months postoperatively with P values of 0.378, 0.931, and 0.934, respectively. There were insignificant differences regarding the patient’s satisfaction and postoperative visual analog scale. Conclusions US guided IIN / IHN block provides good perioperative pain control for inguinal hernia-repair surgeries. Addition of lidocaine (5%) patch may increase patient satisfaction and improve chronic postoperative pain outcome.
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