腹腔镜与开放式肝切除术术中痛觉水平的比较。

Hepato-gastroenterology Pub Date : 2015-03-01
Kazuma Hashimoto, Hiroki Miyawaki, Sachiko Iwayama, Nobutaka Kariya, Tsuneo Tatara, Munetaka Hirose
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引用次数: 0

摘要

背景/目的:围手术期充分抑制伤害感受对于确保良好的术后结果非常重要。虽然腹腔镜手术中的伤害感觉水平通常低于开腹手术,但没有足够的证据支持肝切除术。方法:为了建立一种回顾性评价术中伤害感受水平的方法,我们收集了3例不同程度术中伤害感受的患者术中心率、灌注指数、收缩压的平均值。在我们验证了判别分析的实用性后,我们使用这些变量对手术期间伤害感受进行回顾性评估,我们对接受腹腔镜或开放式肝切除术的患者进行了分析。结果:倾向评分匹配前,开放肝切除术组与腹腔镜肝切除术组的判别评分差异有统计学意义,匹配后两组的判别评分差异无统计学意义。结论:腹腔镜肝切除术的伤害感觉水平可能与开放肝切除术相似。与开放手术一样,在全身麻醉下进行腹腔镜手术可能需要果断的抗伤害策略。
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Comparison of the level of intraoperative nociception between laparoscopic and open hepatic resection.

Background/aims: Sufficient suppression of perioperative nociception is important for ensuring favorable postoperative outcomes. Although the level of nociception during laparoscopic surgery is generally lower than during laparotomy, there is insufficient evidence to support this for hepatic resection.

Methodology: To develop a method to retrospectively evaluate the intraoperative nociceptive level, we collected data of intraoperative averaged values of heart rate, perfusion index, systolic blood pressure during three surgeries with different levels of intraoperative nociception. After we validated the utility of discriminant analysis using these variables for the retrospective evaluation of nociception during surgery, we performed this analysis in patients who underwent either laparoscopic or open hepatic resection.

Results: Although there was a significant difference in discriminant score between the open and the laparoscopic hepatic resection groups before propensity score matching, discriminant score showed no significant difference between two groups after matching.

Conclusions: The level of nociception during laparoscopic hepatic resection is likely similar to that during open hepatic resection. An assertive anti-nociceptive strategy might be required for laparoscopic procedures under general anesthesia, as with open procedures.

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来源期刊
Hepato-gastroenterology
Hepato-gastroenterology 医学-外科
自引率
0.00%
发文量
1
审稿时长
1.9 months
期刊介绍: Hepato-Gastroenterology has been discontinued as of 2015. Extremely limited quantities of back issues in print available for sale.
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