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首页> 外文期刊>Journal of Anaesthesiology Clinical Pharmacology >An observational study to evaluate the effect of different epidural analgesia regimens on dynamic pain scores in patients receiving epidural analgesia for postoperative pain relief after elective gynecological surgery
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An observational study to evaluate the effect of different epidural analgesia regimens on dynamic pain scores in patients receiving epidural analgesia for postoperative pain relief after elective gynecological surgery

机译：评估一项硬膜外镇痛方案对选择性妇科手术后接受硬膜外镇痛以减轻术后疼痛的患者动态疼痛评分的影响的观察性研究

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Background and Aims: The primary measure of efficacy of any analgesic regimen is pain relief, but it is important to measure dynamic pain relief rather than pain relief at rest. Epidural analgesia is an effective technique for postoperative analgesia. The drug combinations given therein (local anesthetics with adjuvants such as opioids/alpha-2 agonists), however, remain a personal choice. The aim of this study was to evaluate dynamic pain scores in patients receiving different epidural analgesia regimens for postoperative pain relief after elective gynecological surgery used in our institution. Material and Methods: One hundred eighty-seven patients enrolled in this study received postoperatively either bupivacaine 0.125% + morphine 0.1 mg/mL (group BM) or bupivacaine 0.125% + fentanyl 2 μg/mL (group BF) or bupivacaine 0.125% + clonidine 1 μg/mL (group C1) or bupivacaine 0.125% + clonidine 2 μg/mL (group C2) by continuous epidural infusion @ 5 mL/h. Differences in dynamic pain scores (on coughing and mobilization), pain scores at rest, sensory and motor blockade, sedation scores, dry mouth, pruritus, nausea, and vomiting were recorded. Also duration of postoperative analgesia, epidural top-ups, requirement of rescue analgesic, and patient satisfaction were determined. All observations were carried out at 1, 2, 4, 8, and 12 h after surgery and then at 8 am, 12 noon, 4 pm, 8 pm on subsequent postoperative day till removal of epidural catheter (after 96 h). Results: There was no difference in demographic or hemodynamic profile among the four groups (P > 0.05). There was no statistically significant difference in pain scores at rest among the four groups but dynamic pain scores were found to be better in group C2 as compared to group BM, BF, and C1 at most of the time intervals although not statistically significant (P > 0.05). Requirement of rescue analgesics was lower in group BM and group C2 as compared to group BF and C1 (P P Conclusions: Combination of clonidine 2 μg/mL to 0.125% bupivacaine @ 5 mL/h in combined spinal epidural provides better postoperative analgesia as compared to combination of bupivacaine with opioids with greater patient satisfaction and significantly reduced side effects.
机译：背景与目的：任何镇痛方案的主要疗效指标是缓解疼痛，但重要的是要测量动态缓解疼痛，而不是静止时缓解疼痛。硬膜外镇痛是一种有效的术后镇痛技术。然而，其中给定的药物组合（局部麻醉剂和佐剂，如阿片类药物/α-2激动剂）仍然是个人选择。本研究的目的是评估在我们机构中使用选择性妇科手术后接受不同硬膜外镇痛方案以减轻术后疼痛的患者的动态疼痛评分。材料和方法：参加本研究的187例患者术后接受布比卡因0.125％+吗啡0.1 mg / mL（BM组）或布比卡因0.125％+芬太尼2μg/ mL（BF组）或布比卡因0.125％+可乐定通过连续硬膜外输注@ 5 mL / h以1μg/ mL（C1组）或布比卡因0.125％+可乐定2μg/ mL（C2组）。记录动态疼痛评分（咳嗽和动员时），静息疼痛评分，感觉和运动阻滞，镇静评分，口干，瘙痒，恶心和呕吐的差异。还确定了术后镇痛的持续时间，硬膜外注药量，急救镇痛的需要量以及患者满意度。所有观察均在术后1、2、4、8和12 h进行，然后在术后第二天的上午8点，中午12点，下午4点，晚上8点进行，直到硬膜外导管取出（96小时后）。结果：四组之间的人口统计学或血液动力学特征无差异（P> 0.05）。四组之间的静止疼痛评分在统计学上无显着差异，但在大多数时间间隔，C2组的动态疼痛评分均优于BM，BF和C1组，尽管无统计学意义（P> 0.05）。与BF和C1组相比，BM组和C2组的急救镇痛剂要求较低（PP结论：联合硬膜外硬膜外联合可乐定2μg/ mL至0.125％布比卡因@ 5 mL / h提供的术后镇痛效果优于布比卡因与阿片类药物合用可提高患者满意度，并显着降低副作用。

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