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首页> 外文期刊>Pain medicine : >Immediate postoperative pain in orthopedic patients is more intense and requires more analgesia than in post-laparotomy patients.
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Immediate postoperative pain in orthopedic patients is more intense and requires more analgesia than in post-laparotomy patients.

机译：与腹腔镜手术后患者相比，骨科患者的术后即刻疼痛更剧烈，需要更多的镇痛作用。

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OBJECTIVE: To compare the immediate postoperative pain intensity between orthopedic and general surgery patients and evaluate the extent of severe pain in each group. DESIGN: Observational, open-label study. SETTING: Post-anesthesia care unit (PACU) in a tertiary, university-affiliated hospital. PATIENTS: Patients undergoing orthopedic surgery or laparotomy under general anesthesia over a one-year period. INTERVENTIONS: Follow-up of patient self-rated pain visual analog scale (VAS, 0-10), and observation of the efficacy of the routine analgesic protocol of morphine, ketamine, and diclofenac administration in the PACU. OUTCOME MEASURES: We followed pain scores and sorted patients according to morphine requirements during the PACU immediate postoperative stay. Patients whose pain was controlled with /=5/10), patients were categorized as suffering from severe pain. They were further treated with repeated doses of 1 mg morphine plus 350 microg/kg ketamine (M+K) and eventually diclofenac. PACU follow-up lasted 3 hours. RESULTS: The overall rate of immediate severe postoperative pain within the entire cohort (3,460 patients) was 9.4%: 123 (6.6%) of laparotomy patients and 202 (12.7%) of orthopedic patients. Pain in the laparotomy patients identified as suffering from severe pain was controlled with 1.21+/-0.45 doses of M+K compared with 1.37+/-0.62 (P<0.0001) in the orthopedic counterparts. One-fifth of these laparotomy patients demanded more than one injection of M+K compared with one-third of the orthopedic subgroup (P=0.045). Twenty-seven orthopedic vs nine surgical patients (P=0.036) required diclofenac. CONCLUSIONS: More orthopedic than laparotomy patients suffered from severe immediate postoperative pain. They required more analgesia than that dictated by existing PACU analgesia protocols. Ketamine and morphine co-administration proved effective in controlling severe postoperative pain after each type of surgery.
机译：目的：比较整形外科患者和普通外科患者术后立即的疼痛强度，并评估每组患者的严重疼痛程度。设计：观察性开放标签研究。地点：大学附属的三级医院中的麻醉后监护室（PACU）。患者：一年内在全身麻醉下接受整形外科手术或剖腹手术的患者。干预措施：对患者自我评估的疼痛视觉模拟评分表（VAS，0-10）进行随访，并观察PACU中吗啡，氯胺酮和双氯芬酸常规镇痛方案的疗效。观察指标：在PACU术后立即住院期间，我们追踪疼痛评分并根据吗啡要求对患者进行分类。疼痛被 / = 5/10），则将患者归类为严重疼痛。他们用重复剂量的1毫克吗啡加350微克/千克氯胺酮（M + K）进一步治疗，并最终服用双氯芬酸。 PACU的随访持续了3个小时。结果：在整个队列（3,460例患者）中，立即发生的严重术后疼痛的总发生率为9.4％：剖腹手术患者为123（6.6％），而骨科患者为202（12.7％）。经鉴定为患有严重疼痛的剖腹手术患者的疼痛由1.21 +/- 0.45剂量的M + K控制，而整形外科患者的疼痛为1.37 +/- 0.62（P <0.0001）。这些剖腹手术患者中有五分之一需要注射多于一次的M + K，而整形外科亚组则需要三分之一（P = 0.045）。二十七例骨科患者与九例外科患者（P = 0.036）需要双氯芬酸。结论：比开腹手术患者遭受严重的立即术后疼痛的矫形术更多。他们需要比现有PACU镇痛方案所规定的更多的镇痛剂。氯胺酮和吗啡的共同给药被证明可有效控制每种手术后的严重术后疼痛。

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