初次与第一次重复剖腹产的术后止痛药消费:一个历史的队列研究
Romel Holmes1, Jong Ok La2, Matthew Fuller2
1Duke University School of Medicine, Durham, NC, USA.
概括
这项研究在使用患者作为自己的对照时,在初级和重复剖腹产 (CD) 之间没有发现术后疼痛或阿片类药物使用的显著差异. 与初级CD相比,重复剖腹产并没有增加阿片类药物消费.
科学领域:
- 产科和妇科 产科和妇科
- 麻醉学 麻醉学
- 疼痛管理 疼痛管理
背景情况:
- 剖腹产后的术后疼痛和阿片类药物消耗可能会有所不同.
- 关于初级CD和重复CD之间的差异存在相互矛盾的结果.
- 之前的研究缺乏患者内部的比较.
研究的目的:
- 为了比较手术后的疼痛和阿片类药物消耗在患者接受初次和第一次重复剖腹产.
- 用患者作为自己的对照来进行更强大的比较.
主要方法:
- 单中心历史队列研究.
- 包括在神经轴麻醉下进行初级CD和第一次重复CD的患者.
- 使用了标准化的多模式止痛和结果测量 (阿片类药物消耗,疼痛评分).
主要成果:
- 在48小时后,阿片类药物消费没有显著差异 (中位数为45毫克OME) 或初级和重复CD之间的二次结果.
- 多变量分析,调整多个因素,显示重复CD与阿片类药物消费增加无关 (调整后率比1.20).
结论:
- 在初次和第一次重复剖腹产之间没有观察到术后阿片类药物消耗或疼痛评分的显著差异.
- 这种患者内部的比较表明,重复的CD并不本质上导致更高的疼痛或阿片类药物需求.
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