[机器人辅助腹腔镜根治性前列腺切除术后静脉或口服对乙酰氨基酚的疗效]。

Q4 Medicine Japanese Journal of Urology Pub Date : 2022-01-01 DOI:10.5980/jpnjurol.113.103
Shuhei Yokokawa, Tadashi Tabei, Katsuya Yamaguchi, Sohgo Tsutsumi, Masashi Imano, Ken Miyama, Hiroki Ito, Kazuki Kobayashi
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引用次数: 0

摘要

(目的)探讨我院机器人辅助腹腔镜根治性前列腺切除术(RARP)术后静脉或口服对乙酰氨基酚的疗效。(对象和方法)我们回顾性分析了2019年4月至2020年12月在我院接受RARP治疗的173例患者。根据术后镇痛药的使用情况将患者分为A、B、C三组。A组患者仅在需要时给予对乙酰氨基酚。B组患者自手术当日至术后第2天,每6 h静脉注射一次对乙酰氨基酚。C组患者术后3 - 7天口服对乙酰氨基酚,同时静脉给予对乙酰氨基酚(与B组相似)。通过多因素分析确定静脉或口服对乙酰氨基酚是否减少了非计划镇痛药物的使用。(结果)A组110例,B组33例,C组30例。A组与B组淋巴结清扫率差异有统计学意义(70.9% vs 36.4%;P=0.001), A组和C组(70.9% vs 33.3%;P < 0.001);此外,术前雄激素阻断治疗的频率在A组和C组之间存在显著差异(20% vs 3.3%;P = 0.029)。Logistic回归分析显示,仅在术后0 ~ 2天静脉和口服对乙酰氨基酚是术后疼痛的独立因素(A组vs B组:OR=0.127;0.046 - -0.355;P< 0.001, A组vs C组:OR=0.133;0.046 - -0.390;P < 0.001)。术后第3 ~ 7天,A组和b组在非计划使用镇痛药方面无显著差异。C组30例患者中仅有1例接受非计划使用镇痛药。(结论)定期静脉或口服对乙酰氨基酚可减少RARP术后非计划镇痛药物的使用。
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[EFFICACY OF SCHEDULED INTRAVENOUS OR ORAL ACETAMINOPHEN ADMINISTRATION AFTER ROBOTIC-ASSISTED LAPAROSCOPIC RADICAL PROSTATECTOMY].

(Purpose) To determine the efficacy of scheduled intravenous or oral acetaminophen administration after robotic-assisted laparoscopic radical prostatectomy (RARP) in our hospital. (Subjects and methods) We retrospectively analyzed 173 patients who underwent RARP at our hospital between April 2019 and December 2020. The patients were divided into three groups (A, B, and C) according to the use of postoperative analgesia. Group A patients were administered acetaminophen only when needed. Group B patients were administered intravenous acetaminophen every 6 h from the day of surgery to postoperative day 2. Group C patients were prescribed oral acetaminophen from 3 to 7 days postoperatively in addition to being administered intravenous acetaminophen (similar to group B). Multivariate analysis was performed to determine whether scheduled intravenous or oral acetaminophen administration reduced unscheduled analgesic use. (Results) There were 110, 33, and 30 patients in groups A, B, and C, respectively. Significant differences in lymph node dissection rates were observed between groups A and B (70.9% vs 36.4%; P=0.001) and groups A and C (70.9% vs 33.3%; P< 0.001); furthermore, significant differences in the frequency of preoperative androgen blockade therapy were observed between groups A and C (20% vs 3.3%; P=0.029). Logistic regression analysis showed that only scheduled intravenous and oral administration of acetaminophen on postoperative days 0 to 2 was an independent factor for postoperative pain (group A vs group B: OR=0.127; 0.046-0.355; P< 0.001 and group A vs group C: OR=0.133; 0.046-0.390; P< 0.001). On postoperative days 3 to 7, there was no significant difference in the unscheduled use of analgesics between groups A and B. Only 1 of the 30 group C patients received unscheduled analgesia. (Conclusions) Scheduled intravenous or oral administration of acetaminophen may reduce unscheduled analgesic use after RARP.

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来源期刊
Japanese Journal of Urology
Japanese Journal of Urology Medicine-Urology
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