双方向サギタス分裂骨折術後の痛みとオピオイド摂取に対する手術前ボトリン毒素Aの効果:ランダム化臨床試験
Kevin E Lung1, Jason Adam2, Clayton Davis1
1Professor, Mike Petryk School of Dentistry, University of Alberta, Edmonton, Canada; Professor, Kingsway Oral and Maxillofacial Surgery, Edmonton, Canada.
まとめ
術前ボツリン毒素A型 (BoNT-A) 注射は,鎮痛薬前での痛みを軽減し,下下の進行手術 (BSSO) の後のオピオイド使用量を減少させた. 疼痛管理におけるその役割を確認するためにさらなる試験が必要である.
科学分野:
- 口腔および面外科手術
- 疼痛管理 疼痛管理
- 神経調節は神経調節によるものです.
背景:
- マンジブラー・アドバンスメント手術後の術後の痛みや筋肉のは,管理するのが難しい.
- 骨格内科外科における急性疼痛制御のためのボツリン毒素A型 (BoNT-A) の有効性は十分に確立されていません.
研究 の 目的:
- 術前のBoNT-Aをテンポラリスとマセーターの筋肉に注射することで,双方向サギタス・スプリット・オステオトミー (BSSO) を受けている患者の痛みやが軽減されるかどうかを評価する.
主な方法:
- BSSOを受ける成人患者を含む前向き,ランダム化,ダブルブラインド,プラセボ対照試験です.
- 患者は,手術前のBoNT-Aまたは塩溶液プラセボ注射を受けた.
- 疼痛の強度,筋肉の,鎮痛剤の消費,患者の満足度は,14日間のプライマリ・アウトカムとセカンダリー・アウトカムでした.
主要な成果:
- BoNT-Aグループは,プラセボグループ (P < .05) と比較して,痛みを鎮痛する前の痛みのスコアが有意に低いことを示しました.
- 14日間のBoNT-Aグループでは,オピオイドの摂取が著しく減少した (P = .046).
- 疼痛緩和後の痛み,非オピオイドの使用,または筋肉のの頻度において,グループ間の有意な違いは見つかりませんでした.
結論:
- 術前BoNT-A注射は,BSSO後の痛み緩和前およびオピオイド摂取を減らすのに有益な補助剤である可能性があります.
- トレンドはBoNT-Aに好意的であったが,すべてのアウトカムで統計的有意性は得られなかった.
- 術後の疼痛管理のためのこれらの予備的な発見を検証するために,より大規模でパワフルな試験が推奨されます.
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