中泌尿道中的术前止痛:一个队列研究
Marcus Ortega1, Mireya Taboada2, Elizabeth Dotson2
1Department of Obstetrics and Gynecology, Division of Urogynecology and Reconstructive Pelvic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. mortega7@mgh.harvard.edu.
International urogynecology journal
|April 30, 2025
概括
在初步分析中,用于中泌尿器吊带手术的术前疼痛药物显示疼痛得分有所改善,但在调整后缺乏统计学意义. 需要进一步的研究,以改善手术后的恢复.
科学领域:
- 泌尿和妇科 泌尿和妇科
- 手术疼痛管理手术疼痛管理
背景情况:
- 压力性尿失禁 (SUI) 影响了许多女性,中泌尿器吊带 (MUS) 程序是常见的手术治疗.
- 手术后增强恢复 (ERAS) 协议建议进行手术前止痛,但其在MUS中的有效性尚未得到充分证实.
研究的目的:
- 调查手术前止痛药对术后疼痛和阿片类药物使用在接受MUS安置的妇女的影响.
- 评估术前镇痛在泌尿外科手术的ERAS协议中的作用.
主要方法:
- 对631名接受MUS安置 (2018-2022) 的女性进行了回顾性队列研究.
- 根据手术前使用止痛药的情况,患者被分组.
- 主要结局:术后疼痛评分和阿片类药物消费;使用多变量回归调整为混因素.
主要成果:
- 接受手术前止痛治疗的患者报告了较低的未调整的术后疼痛得分 (p=0.013) 和更好的疼痛控制 (p=0.014).
- 然而,经过调整后的分析显示,两组之间疼痛评分或阿片类药物消费没有显著差异.
结论:
- 在未经调整的分析中,手术前的疼痛药物显示了改善疼痛控制的趋势,用于MUS手术.
- 调整后的结果表明没有独立的统计学意义,突出显示了疼痛管理的复杂性.
- 进一步的随机试验是必要的,以优化ERAS疼痛策略在泌尿外科手术.
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