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首页> 外文期刊>Acute pain: international journal of acute pain management >Optimal dosing interval for epidural pethidine after Caesarean section
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Optimal dosing interval for epidural pethidine after Caesarean section

机译：剖宫产术后硬膜外哌替啶的最佳给药间隔

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Background: The optimal dosing interval for epidural pethidine after lower segment Caesarean section (LSCS) is unknown. We challenged our current three hourly minimum dosing interval with an hourly dosing interval.Methods: After random assignment, intermittent epidural pethidine (50 mg on demand) was prescribed with a lockout interval of 1 h (group A) or 3 h (group B) for the first day after LSCS. Visual analogue pain scores (VAS 0-100) at rest and on movement were recorded at the time of request and again 30 min after. Side effects and patient satisfaction scores were monitored.Results: Thirty-seven women were enrolled: 18 in group A, 19 in group B. The median (interquartile range) dosing interval was similar in both groups: group A 220 min (178-246 min); group B 233 min (188-241 min). Request for further analgesia occurred at comparable VAS of 26 and 25 at rest and 44 and 43 on movement in groups A and B respectively. Mean pain scores 30 min later were also similar: 5 versus 3 at rest and 13 versus 13 on movement. The pain threshold variability at which analgesia was requested was higher for pain at rest (coefficient of variability, CV, 50%) than for pain with movement (CV 35%).The incidence of troublesome side effects was nausea 16%, pruritus 2.8% and drowsiness 14%. A higher frequency of mild symptoms were reported for pruritus (50%) and drowsiness (57%). Patient satisfaction was high (88%, S.D. 21).Conclusions: Epidural pethidine 50 mg is an effective analgesic after LSCS. A lockout period of 3 h would deny 28% of patient requests. We projected that this denial rate could be reduced to 7% by shortening the lockout period to 2 h. Patient satisfaction scores were high despite frequently reported mild symptoms. Pain on movement is a more reliable indicator of analgesic need than pain at rest.
机译：背景：下段剖腹产（LSCS）后硬膜外哌替啶的最佳给药间隔尚不清楚。我们以每小时一次的给药间隔挑战了目前的三个小时的最小给药间隔。方法：随机分配后，开出间歇性硬膜外哌替啶（按需50 mg），锁定间隔为1小时（A组）或3小时（B组）在LSCS之后的第一天。在要求时和运动后30分钟再次记录静止和运动时的视觉模拟疼痛评分（VAS 0-100）。结果：37名妇女入组：A组18名，B组19名。两组的中位剂量间隔（四分位间距）相似：A组220分钟（178-246岁）分钟）; B组233分钟（188-241分钟）。 A组和B组分别在静止时的VAS分别为26和25，运动时分别为44和43时要求进一步镇痛。 30分钟后的平均疼痛评分也相似：静止时5对3，运动时13对13。要求镇痛的疼痛阈值变异性高于静息疼痛（变异系数，CV，50％），高于运动性疼痛（CV 35％），令人讨厌的副作用发生率为恶心16％，瘙痒为2.8％。和睡意14％。据报告，瘙痒（50％）和嗜睡（57％）的轻度症状发生率更高。患者满意度很高（88％，S.D。21）。结论：硬膜外哌替啶50 mg是LSCS后的有效镇痛药。锁定期3小时将拒绝28％的患者请求。我们预计通过将锁定时间缩短到2小时，可以将拒绝率降低到7％。尽管经常报告症状轻微，但患者满意度仍然很高。运动止痛比静息止痛是更可靠的镇痛需要指标。

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