{"title":"疼痛研究中的吗啡消耗量和/或数字量表:西尔弗曼整合方法(SIA SCORE)","authors":"Okba Laouamri","doi":"10.37275/jacr.v5i1.452","DOIUrl":null,"url":null,"abstract":"Introduction: Ligamentoplasty pain management is dynamic performance, demanding constant vigilance and adaptation. The aim of this prospective study was to compare the analgesic efficacy of three techniques for knee ligamentoplasty using an integration score, the SIA score. \nMethods: The study included 165 patients undergoing primary reconstruction of the anterior cruciate ligament of the knee. The first group, systemic analgesia (SA), received balanced systemic analgesia postoperatively for a minimum of five days, based on Paracetamol, Diclofenac, and a morphine PCA. In addition to the systemic analgesia already described, the second group, femoral analgesia (FA), will benefit from a femoral peri-nervous catheter in the crural position. The third intra-articular analgesia (IAA) group received, in addition to the same systemic analgesia, an infusion through an epidural catheter of 20 ml of 0.125% bupivacaine, followed by maintenance with 8 ml/h of the same local anesthetic via an electric syringe pump for 36 h. Cumulative morphine consumption was assessed, as well as pain at rest, using a numerical scale (EN) from 1 to 10 and an integration of these two parameters. \nResults: Morphine consumption was lower in the AF group. The lowest mean rank was in the AF group, followed by the AIA group, and the difference was statistically significant with an H = 6.89 and a p= 0.032. The difference was significant between the AS group and the AF group (p = 0.09); the other inter-group differences were not significant. 23.2% of patients had an AIS score between [-100, -200], and were in little pain and consumed little morphine (effective treatment); 14.2% of patients had an AIS score between [100, 200] and were in great pain and consumed a lot of morphine (morphine-resistant or very sensitive to pain). \nConclusion: Analgesia in the femoral peri-nerve group was more effective, with a reduction in mean EN compared with the other two groups.","PeriodicalId":496787,"journal":{"name":"Journal of Anesthesiology and Clinical Research","volume":"2 6","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Morphine Consumption and/or Numerical Scale in Pain Studies: Silverman Integrating Approach (SIA SCORE)\",\"authors\":\"Okba Laouamri\",\"doi\":\"10.37275/jacr.v5i1.452\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Introduction: Ligamentoplasty pain management is dynamic performance, demanding constant vigilance and adaptation. The aim of this prospective study was to compare the analgesic efficacy of three techniques for knee ligamentoplasty using an integration score, the SIA score. \\nMethods: The study included 165 patients undergoing primary reconstruction of the anterior cruciate ligament of the knee. The first group, systemic analgesia (SA), received balanced systemic analgesia postoperatively for a minimum of five days, based on Paracetamol, Diclofenac, and a morphine PCA. In addition to the systemic analgesia already described, the second group, femoral analgesia (FA), will benefit from a femoral peri-nervous catheter in the crural position. The third intra-articular analgesia (IAA) group received, in addition to the same systemic analgesia, an infusion through an epidural catheter of 20 ml of 0.125% bupivacaine, followed by maintenance with 8 ml/h of the same local anesthetic via an electric syringe pump for 36 h. Cumulative morphine consumption was assessed, as well as pain at rest, using a numerical scale (EN) from 1 to 10 and an integration of these two parameters. \\nResults: Morphine consumption was lower in the AF group. The lowest mean rank was in the AF group, followed by the AIA group, and the difference was statistically significant with an H = 6.89 and a p= 0.032. The difference was significant between the AS group and the AF group (p = 0.09); the other inter-group differences were not significant. 23.2% of patients had an AIS score between [-100, -200], and were in little pain and consumed little morphine (effective treatment); 14.2% of patients had an AIS score between [100, 200] and were in great pain and consumed a lot of morphine (morphine-resistant or very sensitive to pain). \\nConclusion: Analgesia in the femoral peri-nerve group was more effective, with a reduction in mean EN compared with the other two groups.\",\"PeriodicalId\":496787,\"journal\":{\"name\":\"Journal of Anesthesiology and Clinical Research\",\"volume\":\"2 6\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-01-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Anesthesiology and Clinical Research\",\"FirstCategoryId\":\"0\",\"ListUrlMain\":\"https://doi.org/10.37275/jacr.v5i1.452\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Anesthesiology and Clinical Research","FirstCategoryId":"0","ListUrlMain":"https://doi.org/10.37275/jacr.v5i1.452","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
简介韧带成形术的疼痛管理是一项动态工作,需要不断保持警惕和适应。这项前瞻性研究的目的是使用 SIA 综合评分比较膝关节韧带成形术三种技术的镇痛效果。研究方法研究对象包括 165 名接受膝关节前十字韧带初级重建术的患者。第一组为全身镇痛(SA)组,术后接受至少五天的均衡全身镇痛,镇痛药物包括扑热息痛、双氯芬酸和吗啡 PCA。除上述全身镇痛外,第二组股骨头镇痛(FA)患者还将从脊柱位置的股神经周围导管中获益。第三组为关节内镇痛(IAA)组,除接受同样的全身镇痛外,还通过硬膜外导管输注20毫升0.125%布比卡因,然后通过电动注射泵以8毫升/小时的速度维持36小时。结果显示房颤组的吗啡消耗量较低。房颤组的平均等级最低,其次是AIA组,差异有统计学意义,H=6.89,P=0.032。强直性脊柱炎组和房颤组之间的差异显著(P=0.09),其他组间差异不显著。23.2%的患者的AIS评分在[-100,-200]之间,疼痛轻微,吗啡用量少(治疗有效);14.2%的患者的AIS评分在[100,200]之间,疼痛剧烈,吗啡用量大(吗啡耐受或对疼痛非常敏感)。结论与其他两组相比,股神经周围组的镇痛效果更好,平均EN值有所降低。
Introduction: Ligamentoplasty pain management is dynamic performance, demanding constant vigilance and adaptation. The aim of this prospective study was to compare the analgesic efficacy of three techniques for knee ligamentoplasty using an integration score, the SIA score.
Methods: The study included 165 patients undergoing primary reconstruction of the anterior cruciate ligament of the knee. The first group, systemic analgesia (SA), received balanced systemic analgesia postoperatively for a minimum of five days, based on Paracetamol, Diclofenac, and a morphine PCA. In addition to the systemic analgesia already described, the second group, femoral analgesia (FA), will benefit from a femoral peri-nervous catheter in the crural position. The third intra-articular analgesia (IAA) group received, in addition to the same systemic analgesia, an infusion through an epidural catheter of 20 ml of 0.125% bupivacaine, followed by maintenance with 8 ml/h of the same local anesthetic via an electric syringe pump for 36 h. Cumulative morphine consumption was assessed, as well as pain at rest, using a numerical scale (EN) from 1 to 10 and an integration of these two parameters.
Results: Morphine consumption was lower in the AF group. The lowest mean rank was in the AF group, followed by the AIA group, and the difference was statistically significant with an H = 6.89 and a p= 0.032. The difference was significant between the AS group and the AF group (p = 0.09); the other inter-group differences were not significant. 23.2% of patients had an AIS score between [-100, -200], and were in little pain and consumed little morphine (effective treatment); 14.2% of patients had an AIS score between [100, 200] and were in great pain and consumed a lot of morphine (morphine-resistant or very sensitive to pain).
Conclusion: Analgesia in the femoral peri-nerve group was more effective, with a reduction in mean EN compared with the other two groups.