Postoperative pain is the most common complaint after laparoscopic cholecystectomy. This study was carried out to evaluate whether preoperative administration of intramuscular dezocine can provide postoperative analge...Postoperative pain is the most common complaint after laparoscopic cholecystectomy. This study was carried out to evaluate whether preoperative administration of intramuscular dezocine can provide postoperative analgesia and reduce postoperative opioid consumption in patients undergoing laparoscopic cholecystectomy. Patients （ASA Ⅰ or Ⅱ ） scheduled for laparoscopic cholecystectomy were randomly assigned into intramuscular dezocine group （group 1） or intramuscular normal saline group （group 2）. Dezocine and equal volume normal saline were administered intramuscularly 10 rain before the induction of anesthesia. After operation, the severity of postoperative pain, postoperative fentanyl requirement, incidence and severity of side-effects were assessed. Postoperative pain and postoperative patient-controlled fentanyl consumption were reduced significantly in group l compared with group 2. The incidence and severity of side effects were similar between the two groups. Preoperative single-dose administration of intramuscular dezocine 0.1 mg/kg was effective in reducing postoperative pain and postoperative patient-controlled fentanyl requirement in patients undergoing laparoscopic cholecystectomy.展开更多
AIM:To determine the efficacy of perioperative parecoxib injection on postoperative pain relief after laparoscopic cholecystectomy.METHODS: A prospective, double-blind, randomized, placebo-controlled study was conduct...AIM:To determine the efficacy of perioperative parecoxib injection on postoperative pain relief after laparoscopic cholecystectomy.METHODS: A prospective, double-blind, randomized, placebo-controlled study was conducted on 70 patients who underwent elective laparoscopic cholecystectomy under general anesthesia at Siriraj Hospital, Bangkok, from January 2006 to December 2007. Patients were randomized to receive either 20 mg parecoxib infusion 30 min before induction of anesthesia and at 12 h after the first dose (treatment group), or normal saline infusion, in the same schedule, as a placebo (control group). The degree of the postoperative pain was assessed every 3 h in the first 24 h after surgery, and then every 12 h the following day, using a visual analog scale. The consumption of analgesics was also recorded.RESULTS:There were 40 patients in the treatment group, and 30 patients in the control group. The pain scores at each time point, and analgesic consumption did not differ between the two groups. However,there were fewer patients in the treatment group than placebo group who required opioid infusion within the first 24 h (60% vs 37%, P=0.053).CONCLUSION: Perioperative administration of parecoxib provided no significant effect on postoperative pain relief after laparoscopic cholecystectomy. However, preoperative infusion 20 mg parecoxib could significantly reduce the postoperative opioid consumption.展开更多
Background： We undertook a randomized controlled trial to ascertain if single-incision laparoscopic cholecystectomy （SILC） was more beneficial for reducing postoperative pain than traditional laparoscopic cholecyst...Background： We undertook a randomized controlled trial to ascertain if single-incision laparoscopic cholecystectomy （SILC） was more beneficial for reducing postoperative pain than traditional laparoscopic cholecystectomy （TLC）. Moreover, the influencing factors of SI LC were analyzed. Methods： A total of 552 patients with symptomatic gallstones or polyps were allocated randomly to undergo SILC （n = 138） or TLC （n - 414）. Data on postoperative pain score, operative time, complications, procedure conversion, and hospital costs were collected. After a 6-month follow-up, all data were analyzed using the intention-to-treat principle. Results： Among SILC group, 4 （2.9%） cases required conversion to TLC. Mean operative time of SILC was significantly longer than that of TLC （58.97 ± 21.56 vs. 43.38 ± 19.02 min, P 〈 0.001）. The two groups showed no significant differences in analgesic dose, duration of hospital stay, or cost. Median pain scores were similar between the two groups 7 days after surgery, but SILC-treated patients had a significantly lower median pain score 6 h after surgery （10-point scale： 3 [2, 4] vs. 4 [3, 5], P = 0.009）. Importantly, subgroup analyses of operative time for SILC showed that a longer operative time was associated with greater prevalence of pain score 〉5 （≥100 min： 5/7 patients vs. 〈40 min, 3/16 patients, P = 0.015）. Conclusions： The primary benefit of SILC appears to be slightly less pain immediately after surgery. Surgeon training seems to be important because the shorter operative time for SILC may elicit less pain immediately after surgery.展开更多
目的:探讨罗伊适应模式护理在腹腔镜胆囊切除术(LC)患者中的应用效果。方法:选取2020年7月至2023年3月在该院行LC治疗的126例胆囊结石患者进行前瞻性研究,按照随机数字表法将其分为研究组和对照组各63例。对照组采用常规围术期护理,研...目的:探讨罗伊适应模式护理在腹腔镜胆囊切除术(LC)患者中的应用效果。方法:选取2020年7月至2023年3月在该院行LC治疗的126例胆囊结石患者进行前瞻性研究,按照随机数字表法将其分为研究组和对照组各63例。对照组采用常规围术期护理,研究组在对照组基础上采用罗伊适应模式护理。比较两组护理后自我护理能力量表(ESCA)评分、术后恢复指标[首次下床活动时间、首次排气时间、住院时间及术后48 h视觉模拟评分法(VAS)评分]、护理前后负性情绪[广泛性焦虑障碍量表(GAD-7)、患者健康问卷抑郁自评量表(PHQ-9)]评分,以及并发症发生率。结果:护理后,研究组ESCA评分高于对照组,GAD-7、PHQ-9评分均低于对照组,差异有统计学意义(P<0.05);研究组首次下床活动时间、首次排气时间和住院时间均短于对照组,术后48 h VAS评分低于对照组,差异有统计学意义(P<0.05);研究组并发症发生率为4.76%(3/63),低于对照组的15.87%(10/63),差异有统计学意义(P<0.05)。结论:罗伊适应模式护理用于LC患者能够提高其自我护理能力,缩短首次下床活动时间、首次排气时间和住院时间,降低术后并发症发生率、VAS评分及焦虑、抑郁评分,效果优于常规护理。展开更多
文摘Postoperative pain is the most common complaint after laparoscopic cholecystectomy. This study was carried out to evaluate whether preoperative administration of intramuscular dezocine can provide postoperative analgesia and reduce postoperative opioid consumption in patients undergoing laparoscopic cholecystectomy. Patients （ASA Ⅰ or Ⅱ ） scheduled for laparoscopic cholecystectomy were randomly assigned into intramuscular dezocine group （group 1） or intramuscular normal saline group （group 2）. Dezocine and equal volume normal saline were administered intramuscularly 10 rain before the induction of anesthesia. After operation, the severity of postoperative pain, postoperative fentanyl requirement, incidence and severity of side-effects were assessed. Postoperative pain and postoperative patient-controlled fentanyl consumption were reduced significantly in group l compared with group 2. The incidence and severity of side effects were similar between the two groups. Preoperative single-dose administration of intramuscular dezocine 0.1 mg/kg was effective in reducing postoperative pain and postoperative patient-controlled fentanyl requirement in patients undergoing laparoscopic cholecystectomy.
基金Supported by Faculty of Medicine Siriraj Hospital Research Project Grant
文摘AIM:To determine the efficacy of perioperative parecoxib injection on postoperative pain relief after laparoscopic cholecystectomy.METHODS: A prospective, double-blind, randomized, placebo-controlled study was conducted on 70 patients who underwent elective laparoscopic cholecystectomy under general anesthesia at Siriraj Hospital, Bangkok, from January 2006 to December 2007. Patients were randomized to receive either 20 mg parecoxib infusion 30 min before induction of anesthesia and at 12 h after the first dose (treatment group), or normal saline infusion, in the same schedule, as a placebo (control group). The degree of the postoperative pain was assessed every 3 h in the first 24 h after surgery, and then every 12 h the following day, using a visual analog scale. The consumption of analgesics was also recorded.RESULTS:There were 40 patients in the treatment group, and 30 patients in the control group. The pain scores at each time point, and analgesic consumption did not differ between the two groups. However,there were fewer patients in the treatment group than placebo group who required opioid infusion within the first 24 h (60% vs 37%, P=0.053).CONCLUSION: Perioperative administration of parecoxib provided no significant effect on postoperative pain relief after laparoscopic cholecystectomy. However, preoperative infusion 20 mg parecoxib could significantly reduce the postoperative opioid consumption.
文摘Background： We undertook a randomized controlled trial to ascertain if single-incision laparoscopic cholecystectomy （SILC） was more beneficial for reducing postoperative pain than traditional laparoscopic cholecystectomy （TLC）. Moreover, the influencing factors of SI LC were analyzed. Methods： A total of 552 patients with symptomatic gallstones or polyps were allocated randomly to undergo SILC （n = 138） or TLC （n - 414）. Data on postoperative pain score, operative time, complications, procedure conversion, and hospital costs were collected. After a 6-month follow-up, all data were analyzed using the intention-to-treat principle. Results： Among SILC group, 4 （2.9%） cases required conversion to TLC. Mean operative time of SILC was significantly longer than that of TLC （58.97 ± 21.56 vs. 43.38 ± 19.02 min, P 〈 0.001）. The two groups showed no significant differences in analgesic dose, duration of hospital stay, or cost. Median pain scores were similar between the two groups 7 days after surgery, but SILC-treated patients had a significantly lower median pain score 6 h after surgery （10-point scale： 3 [2, 4] vs. 4 [3, 5], P = 0.009）. Importantly, subgroup analyses of operative time for SILC showed that a longer operative time was associated with greater prevalence of pain score 〉5 （≥100 min： 5/7 patients vs. 〈40 min, 3/16 patients, P = 0.015）. Conclusions： The primary benefit of SILC appears to be slightly less pain immediately after surgery. Surgeon training seems to be important because the shorter operative time for SILC may elicit less pain immediately after surgery.
文摘目的:探讨罗伊适应模式护理在腹腔镜胆囊切除术(LC)患者中的应用效果。方法:选取2020年7月至2023年3月在该院行LC治疗的126例胆囊结石患者进行前瞻性研究,按照随机数字表法将其分为研究组和对照组各63例。对照组采用常规围术期护理,研究组在对照组基础上采用罗伊适应模式护理。比较两组护理后自我护理能力量表(ESCA)评分、术后恢复指标[首次下床活动时间、首次排气时间、住院时间及术后48 h视觉模拟评分法(VAS)评分]、护理前后负性情绪[广泛性焦虑障碍量表(GAD-7)、患者健康问卷抑郁自评量表(PHQ-9)]评分,以及并发症发生率。结果:护理后,研究组ESCA评分高于对照组,GAD-7、PHQ-9评分均低于对照组,差异有统计学意义(P<0.05);研究组首次下床活动时间、首次排气时间和住院时间均短于对照组,术后48 h VAS评分低于对照组,差异有统计学意义(P<0.05);研究组并发症发生率为4.76%(3/63),低于对照组的15.87%(10/63),差异有统计学意义(P<0.05)。结论:罗伊适应模式护理用于LC患者能够提高其自我护理能力,缩短首次下床活动时间、首次排气时间和住院时间,降低术后并发症发生率、VAS评分及焦虑、抑郁评分,效果优于常规护理。
