减轻Maharat Nakhonratchasima医院妇科腹腔镜手术后肩痛的简单临床操作:一项随机对照试验

Chatchai Jantaweetip
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引用次数: 0

摘要

目的:评价临床简单手法减轻妇科腹腔镜术后肩痛的效果。研究设计:随机对照试验。方法:104例计划进行选择性妇科腹腔镜手术的患者被随机分配到当前标准组作为对照组,或在手术结束时额外努力去除残余CO 2。对照组54例患者,通过插管被动放气腹腔排出co2。而在干预组的50例患者中,通过Trendelenbrerg体位(30度)和由5次手动肺充气组成的肺复吸手法去除CO 2。术后肩痛在术后24、48小时用口头评定量表(VRS 1-6)记录。结果:两组患者在年龄、手术时间、手术类型、体重指数等方面差异均无统计学意义(p < 0.001),但对照组患者术后住院时间(平均SD)为2.5 + 0.57天,干预组患者为2.1 + 0.47天(p < 0.001)。评估术后48小时内肩痛(VRS 2-6)。干预组50例患者中有11例(22%)出现明显疼痛,对照组54例患者中有34例(63%)出现明显疼痛(p < 0.001)。结论:这种简单的临床手法可以减少妇科腹腔镜手术后肩痛的主诉人数,具有统计学意义。
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Simple Clinical Maneuver for Reducing Shoulder Pain Following Gynecologic Laparoscopic Surgery at Maharat Nakhonratchasima Hospital: A Randomized Controlled Trial
Objective: To assess the efficacy of simple clinical maneuver to reduce shoulder pain after gynecologic laparoscopic surgery. Study design: Randomized controlled trial. Method: One hundred and four patients who were scheduled for elective gynecologic laparoscopic surgery were randomly allocated to either the current standard as a control group or to additional efforts to remove residual CO 2 at the end of surgery groups. For 54 patients in control group, CO 2 was removed by passive deflation of the abdominal cavity through the cannula. While in 50 patients in the intervention group, CO 2 was removed by means of Trendelenbrerg position (30 degrees) and a pulmonary recruitment maneuver consisting of 5 manual inflations of lung . Postoperative shoulder pain was recorded on a verbal rating scale (VRS 1-6) at 24, 48 hours after operation. Result: There are no significant differences in age, time of surgery, type of surgery, body mass index between 2 groups  except for the postoperative hospital stay (mean,SD)  which are 2.5 + 0.57 days in the control group compared to 2.1 + 0.47 days in the intervention group (p < 0.001). Postoperative shoulder pain (VRS 2-6) in first 48 hrs was evaluated. The significant pain is found in11 in 50 patients (22%) in the intervention group compared with34 in 54 patients (63%) in the control group (p < 0.001). Conclusion: This simple clinical maneuver can reduce the number of patients complaining of shoulder pain after Gynecologic laparoscopic surgery with statistical significance.
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来源期刊
Thai Journal of Obstetrics and Gynaecology
Thai Journal of Obstetrics and Gynaecology Medicine-Obstetrics and Gynecology
CiteScore
0.40
自引率
0.00%
发文量
3
审稿时长
24 weeks
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