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首页> 外文期刊>The Journal of the American Association of Gynecologic Laparoscopists >Effects of closed suction drainage in reducing pain after laparoscopic-assisted vaginal hysterectomy.
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Effects of closed suction drainage in reducing pain after laparoscopic-assisted vaginal hysterectomy.

机译：腹腔镜辅助阴道子宫切除术后闭合抽吸引流对减轻疼痛的作用。

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STUDY OBJECTIVE: To estimate whether closed suction drainage of the pelvis after laparoscopic-assisted vaginal hysterectomy (LAVH) reduces the frequency and intensity of shoulder-tip, abdominal, and back pain. DESIGN: Prospective, randomized study (Canadian Task Force classification 1). SETTING: Teaching medical center. PATIENTS: One hundred sixty-four women. INTERVENTION: LAVH. MEASUREMENTS AND MAIN RESULTS: For group 1 (80 women), closed suction (Jackson-Pratt) drains were inserted into the peritoneal cavity and cul-de-sac, whereas for group 2 (84), no drains were placed. Shoulder-tip, abdominal, and back pain were evaluated by visual analog scores (VAS) 3, 24, and 48 hours after surgery. The frequency of shoulder-tip pain was significantly lower in group 1 at 24 hours (23% vs 40%, p = 0.013) and 48 hours (9% vs 21%, p = 0.024; VAS scores at 24 hrs 2.2 +/- 1.1 vs 3.8 +/- 1.3, p = 0.010; VAS scores at 48 hours 1.5 +/- 1.0 vs 2.5 +/- 1.2, p = 0.018). At 48 hours fewer women in group 1 experienced abdominal pain (31% vs 50%, p = 0.039; VAS scores 2.0 +/- 1.1 vs 4.0 +/- 1.3, p = 0.007). No statistically significant differences in frequency and VAS scores for back pain were found at any time. The quantity of oral analgesics was greater for group 2 than for group 1 (12.4 +/- 1.6 vs 9.0 +/- 1.4, p <0.001). Economic evaluation of analgesic requirements and material costs for the two groups showed that simple analgesics were more cost-effective than closed suction drainage in the treatment of pain. CONCLUSION: Closed suction drains may reduce the frequency and intensity of shoulder-tip and abdominal pain and postoperative analgesia requirements after LAVH, but simple oral analgesics are more cost effective.
机译：研究目的：估计腹腔镜辅助阴道子宫切除术（LAVH）后骨盆的闭合吸引引流是否能减少肩尖，腹部和背部疼痛的频率和强度。设计：前瞻性随机研究（加拿大工作组分类1）。地点：教学医学中心。患者：164名女性。干预：洗礼。测量和主要结果：对于第1组（80名妇女），将封闭的抽吸（杰克逊-普拉特）引流管插入腹膜腔和死路，而对于第2组（84），未放置引流管。术后3、24和48小时通过视觉模拟评分（VAS）评估肩尖，腹部和背部疼痛。第1组在24小时（23％vs 40％，p = 0.013）和48小时（9％vs 21％，p = 0.024）的肩尖疼痛发生率显着降低; 24小时时的VAS评分2.2 +/- 1.1 vs 3.8 +/- 1.3，p = 0.010; 48小时时的VAS评分1.5 +/- 1.0 vs 2.5 +/- 1.2，p = 0.018）。在第48小时，第1组中较少的女性出现腹痛（31％比50％，p = 0.039; VAS评分为2.0 +/- 1.1与4.0 +/- 1.3，p = 0.007）。在任何时候都没有发现背痛发生频率和VAS评分的统计显着差异。第2组的口服镇痛药数量大于第1组（12.4 +/- 1.6对9.0 +/- 1.4，p <0.001）。两组镇痛剂需求和材料成本的经济评估表明，在镇痛方面，简单的镇痛剂比封闭式抽吸引流更具成本效益。结论：封闭的引流管可减少LAVH术后肩尖和腹痛的频率和强度以及术后镇痛的需要，但简单的口服镇痛药更具成本效益。

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