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首页> 外文期刊>Pain Studies and Treatment >Perioperative Local Cooling Reduce Significantly Early Pain after Open Inguinal Hernia Repair: A Prospective Randomized Study
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Perioperative Local Cooling Reduce Significantly Early Pain after Open Inguinal Hernia Repair: A Prospective Randomized Study

机译：围手术期局部降温显着减少开放性腹股沟疝修补术后的早期疼痛：一项前瞻性随机研究

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Pain and local complications are the major determinants of outcome after inguinal hernia repair. To evaluate the respective impact of peri-operative cooling of surgical site and usual care after open inguinal hernia repair, we performed a prospective randomized study. Methods: One hundred and eight consecutive patients with primary unilateral inguinal hernia were included the study. Repair was performed by local direct access during ambulatory surgery. The first study group underwent standard pre- and postoperative local care (control group). In the second group (cold compress group), a single-use disposable sterile cold compress was applied on the surgical site for at least 30 minutes before and 2 hours after surgery. Primary endpoints were immediate postoperative pain using a visual analogue scale, and local complications. Secondary endpoints included: analgesic drug consumption, length of hospital stay, delay to return to normal activity and patient satisfaction. Results: There was no difference concerning operative time (36.3 ± 14.0 vs 39.6 ± 7.2 minutes) and early (one-week) complications, although there was a non significant reduced incidence of hematoma and ecchymosis (0/54 versus 4/54) for the cold compress group. Analgesic drug consumption was significantly (p = 0.01) reduced. During the day of surgery and the first postoperative day, the visual analogue scale was significantly lower after cooling. There was a non-significant reduction in length of hospital stay (150 ± 37 versus 210 ± 47 min), and time to return to normal activity was shorter in the cold compress group. Conclusion: For open inguinal hernia repair, immediate pre- and post operative surgical site cooling, targeting a controlled temperature between 12?C and 15?C significantly reduced postoperative pain, analgesic drug consumption and resulted in improved immediate outcomes. This technique is safe, simple, easy to use, inexpensive and well tolerated by the patient.
机译：腹股沟疝修补术后疼痛和局部并发症是预后的主要决定因素。为了评估开放性腹股沟疝修补术后围手术期降温和常规护理的各自影响，我们进行了一项前瞻性随机研究。方法：本研究纳入了118例原发性单侧腹股沟疝患者。通过非卧床手术中的局部直接进入进行修复。第一个研究组接受标准的术前和术后局部护理（对照组）。在第二组（冷敷组）中，在手术前和手术后2小时内在手术部位一次性使用一次性无菌无菌冷敷。主要终点是使用视觉模拟量表进行的术后即刻疼痛和局部并发症。次要终点包括：止痛药消费，住院时间，恢复正常活动的延迟和患者满意度。结果：尽管手术时间（36.3±14.0 vs 39.6±7.2分钟）和早期（一周）并发症没有差异，但对于血肿和瘀斑的发生率无明显降低（0/54对4/54）冷敷组。镇痛药的消耗量明显减少（p = 0.01）。在手术当天和术后第一天，冷却后视觉模拟评分明显降低。冷敷组的住院时间无明显减少（150±37 vs 210±47 min），恢复正常活动的时间较短。结论：对于开放性腹股沟疝修补术，术前和术后立即进行手术部位降温，目标温度控制在12？C和15？C之间，可显着减少术后疼痛，镇痛药物的消耗，并改善即时结果。该技术是安全，简单，易于使用，廉价且患者可以很好耐受的。

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