多模式镇痛能否减少肩关节镜手术患者的术后阿片类药物用量?一项回顾性研究。

IF 0.9 4区 医学 Q3 SURGERY
Liming Fang, Mingkun Yu, Zhifeng Tang
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引用次数: 0

摘要

目的:本研究旨在探讨多模式镇痛能否减少肩关节镜手术患者术后阿片类药物的用量:对 2022 年 10 月至 2023 年 11 月期间在我院接受肩峰成形术的肩峰下撞击综合征患者进行回顾性分析。根据术后疼痛治疗方法将患者分为观察组和对照组。对照组接受静脉自控电子镇痛(舒芬太尼注射液 1 μg/kg + 丁吗啡诺注射液 4 mg + 0.9% 氯化钠注射液至 100 mL),观察组则接受多模式镇痛(罗哌卡因髋臼下泵 3 mL/h,联合口服塞来昔布和对乙酰氨基酚)。记录术前和术后不同时间点的视觉模拟量表(VAS)评分,比较两组间阿片类药物的使用量、住院时间和术后一周内与镇痛相关的并发症。治疗后1天和1周还对36项简表健康调查(SF-36)评分和康斯坦丁-默利评分(CMS)进行了评估:研究共纳入 132 名患者,其中观察组 66 人,对照组 66 人。观察组在术后 8 小时(T1)、24 小时(T2)和 48 小时(T3)的疼痛强度均显著低于对照组(P < 0.05)。此外,观察组的阿片类药物用量和并发症发生率也明显低于对照组(P < 0.05)。治疗一周后,观察组的 SF-36 评分和 CMS 评分明显高于对照组(P < 0.05):结论:肩关节镜手术后,多模式镇痛可有效减少阿片类药物的用量,降低并发症发生率,并提供有效的短期疼痛缓解。这种方法对改善患者预后具有重要意义。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Can Multimodal Analgesia Reduce Postoperative Opioid Consumption in Patients Undergoing Shoulder Arthroscopy? A Retrospective Study.

Aim: The aim of this study was to investigate whether multimodal analgesia can decrease postoperative opioid usage in patients undergoing shoulder arthroscopy.

Methods: Patients diagnosed with subacromial impingement syndrome who underwent acromioplasty at our institution between October 2022 and November 2023 were retrospectively analyzed. Patients were divided into an observation group and a control group based on postoperative pain management methods. The control group received intravenous self-controlled electronic analgesia (sufentanil injection 1 μg/kg + butorphanol injection 4 mg + 0.9% NaCl injection to 100 mL), while the observation group received multimodal analgesia (ropivacaine subacromial pump 3 mL/h, combined with oral celecoxib and acetaminophen). Visual Analog Scale (VAS) scores were recorded preoperatively and at various postoperative time points, and opioid usage, length of hospital stay, and analgesia-related complications within 1 week postoperatively were compared between groups. The 36-item Short Form Health Survey (SF-36) scores and the Constant-Murley score (CMS), were also assessed 1 day and 1 week after treatment.

Results: One hundred thirty-two patients were included in the study, 66 in the observation group and 66 in the control group. In the control group, there were 46 males and 20 females, with a mean age of 55.47 ± 11.42 years and in the observation group 44 males and 22 females, with a mean age of 56.13 ± 12.19 years The observation group consistently reported significantly lower pain intensity compared to the control group at 8 h (T1), 24 (T2), and 48 h (T3) after surgery (p < 0.05). Additionally, the observation group exhibited significantly lower opioid usage and complication rates compared to the control group (p < 0.05). SF-36 scores and CMS scores were significantly higher in the observation group 1 week after treatment compared to the control group (p < 0.05).

Conclusions: Following shoulder arthroscopy, multimodal analgesia effectively reduces opioid consumption, lowers complication rates, and provides effective short-term pain relief. This approach carries significant implications for improving patient outcomes.

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来源期刊
CiteScore
0.90
自引率
12.50%
发文量
116
审稿时长
>12 weeks
期刊介绍: Annali Italiani di Chirurgia is a bimonthly journal and covers all aspects of surgery:elective, emergency and experimental surgery, as well as problems involving technology, teaching, organization and forensic medicine. The articles are published in Italian or English, though English is preferred because it facilitates the international diffusion of the journal (v.Guidelines for Authors and Norme per gli Autori). The articles published are divided into three main sections:editorials, original articles, and case reports and innovations.
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