肝肿瘤热消融术后疼痛体验的性别差异:一项回顾性研究

IF 2.8 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
R R M M Knapen, M C Homberg, A J R Balthasar, K Jans, S M J Van Kuijk, S W de Boer, E A C Bouman, C Van der Leij
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引用次数: 0

摘要

导言文献显示,不同性别对疼痛的体验存在差异。肝脏热消融术对疼痛体验的确切影响尚不清楚。本研究旨在调查经皮肝脏热消融术后男性和女性恢复期的最大疼痛强度:回顾性纳入2018年至2022年间在马斯特里赫特大学医学中心+接受经皮肝脏热消融术(射频或微波消融术)治疗的原发性或继发性肝脏肿瘤患者。结果包括恢复室的最大数字评分量表(NRS,评分标准:0-10)得分、术后疼痛发生率(定义为 NRS 得分≥4)、麻醉持续时间、恢复室停留时间和并发症。回归分析对年龄、ASA评分、体重指数、肿瘤类型、病变最大直径、患者慢性疼痛史和心理障碍史进行了调整:共纳入 183 名患者,其中 123 名男性(67%)。结果显示,女性患者的平均最大 NRS 评分高于男性(平均值:3.88 对 2.73),但调整后差异不大(α:0.75,95%CI:-0.13-1.64)。与男性相比,女性术后急性疼痛的比例更高(59% 对 35%;aOR:2.50,95%CI:1.16-5.39),在恢复室需要镇痛剂的次数也更多(aOR:2.43,95%CI:1.07-5.48)。到达恢复室时的 NRS 评分没有明显差异(α:0.37,95%CI:-0.48-1.22)。恢复期停留时间、麻醉持续时间、手术时间和并发症发生率均无差异。肿瘤位置(囊下或深部)、每位患者的肿瘤总数以及原发性和继发性肿瘤的区别对NRS没有影响:这项回顾性单中心研究显示,女性肝脏热消融术后疼痛率较高,因此在恢复室使用的镇痛剂也较多。研究结果表明,在对女性进行肝脏热消融术时,应考虑加大镇痛剂的用量,以减轻术后疼痛。证据级别3:非对照回顾性队列研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Sex-Differences in Post-Procedural Pain Experiences After Thermal Liver Ablations for Liver Tumors: A Retrospective Study.

Sex-Differences in Post-Procedural Pain Experiences After Thermal Liver Ablations for Liver Tumors: A Retrospective Study.

Introduction: Literature shows differences in pain experiences between sexes. The exact influence of thermal liver ablation on experienced pain is still not well-known. This study aims to investigate the maximum pain intensity at the recovery between men and women after percutaneous thermal liver ablation.

Methods: Patients treated with percutaneous thermal liver ablation (radiofrequency or microwave ablation) in Maastricht University Medical Center + between 2018 and 2022 for primary or secondary liver tumors were included retrospectively. Outcomes included maximum numerical rating scale (NRS, scale:0-10) score at the recovery room, prevalence of post-procedural pain (defined as NRS score ≥ 4), duration of anesthesia, length of stay at recovery, and complications. Regression analyses were adjusted for age, ASA-score, BMI, tumor type, maximum diameter of lesion, chronic pain in patients' history, and history of psychological disorder.

Results: 183 patients were included of which 123 men (67%). Results showed higher average maximum NRS scores in women patients compared to men (mean:3.88 versus 2.73), but not after adjustments (aß:0.75, 95%CI:-0.13-1.64). Women suffered more from acute post-procedural pain (59% versus 35%; aOR:2.50, 95%CI:1.16-5.39), and needed analgesics more often at the recovery room (aOR:2.43, 95%CI:1.07-5.48) compared to men. NRS score at recovery arrival did not significantly differ (aß:0.37, 95%CI:-0.48-1.22). No differences were seen in the length of stay at the recovery, duration of anesthesia, procedure time, and complication rate. Location of the tumor (subcapsular or deep), total tumors per patient, and distinction between primary and secondary tumors had no influence on the NRS.

Conclusion: This retrospective single-center study shows higher post-procedural pain rates after thermal liver ablation in women, resulting in higher analgesics use at the recovery room. The results suggest considering higher dosage of analgesics during thermal liver ablation in women to reduce post-procedural pain. LEVEL OF EVIDENCE 3: Non-controlled retrospective cohort study.

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来源期刊
CiteScore
5.50
自引率
13.80%
发文量
306
审稿时长
3-8 weeks
期刊介绍: CardioVascular and Interventional Radiology (CVIR) is the official journal of the Cardiovascular and Interventional Radiological Society of Europe, and is also the official organ of a number of additional distinguished national and international interventional radiological societies. CVIR publishes double blinded peer-reviewed original research work including clinical and laboratory investigations, technical notes, case reports, works in progress, and letters to the editor, as well as review articles, pictorial essays, editorials, and special invited submissions in the field of vascular and interventional radiology. Beside the communication of the latest research results in this field, it is also the aim of CVIR to support continuous medical education. Articles that are accepted for publication are done so with the understanding that they, or their substantive contents, have not been and will not be submitted to any other publication.
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