超前平衡镇痛在混合痔术中的临床应用_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 李晓萍 , 孟金 ,  殷志韬 , 张铁辉 , 赵岫 , 贺迟

沈阳市肛肠医院肛肠科（辽宁沈阳 110000）;

Corresponding author：

殷志韬, Email: yinzhitao1971@sina.com

Keywords：

超前平衡镇痛; 混合痔; 手术

DOI：

10.7507/1007-9424.20150263

Video：

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目的比较混合痔手术中超前平衡镇痛和自控泵镇痛的镇痛效果。方法对2012～2014年期间于我院行混合痔外剥内扎术治疗且符合纳入标准的400例混合痔患者的临床资料进行回顾性分析，根据镇痛处理措施分为超前平衡镇痛组和自控泵镇痛组，观察比较2组术后未排便静息状态下及术后首次排便后疼痛视觉模拟量表（VAS）评分及疼痛首次出现时间及末次疼痛消失时间。结果在术后未排便静息状态下及术后首次排便后，超前平衡镇痛组的镇痛效果的VAS评分均明显低于自控泵镇痛组（P＜0.05），超前平衡镇痛组较自控泵镇痛组术后首次疼痛出现时间晚（P＜0.05），而末次疼痛消失时间早（P＜0.05）。结论超前平衡镇痛在混合痔手术中的镇痛效果明显优于传统的单一自控泵镇痛。

Citation： 李晓萍, 孟金, 殷志韬, 张铁辉, 赵岫, 贺迟. 超前平衡镇痛在混合痔术中的临床应用. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2015, 22(8): 1001-1002. doi: 10.7507/1007-9424.20150263 Copy

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11.	Woolf CJ. Evidence for a central component of post-injury pain hypersensitivity. Nature, 1984, 306(5944):686-688.
12.	Reuben SS, Buvanendran A. Preventing the development of chronic pain after orthopaedic surgery with preventive multimodal analgesic techniques. J Bone Joint Surg Am, 2007, 89(6):1343-1358.
13.	McCartney CJ, Sinha A, Katz J. A qualitative systematic review of the role of N-methyl-D-aspartate receptor antagonists in preventive analgesia. Anesth Analg, 2004, 98(5):1385-1400.
14.	Bong CL, Samuel M, Ng JM, et al. Effects of preemptive epidural an-algesia on post-thoracotomy pain. J Cardiothorac Vasc Anesth, 2005, 19(6):786-793.
15.	Møiniche S, Kehlet H, Dahl JB. A qualitative and quantitative systematic review of preemptive analgesia for postoperative pain relief:the role of timing of analgesia. Anesthesiology, 2002, 96(3):725-741.
16.	Jack NM, Liem EB, Vonhögen LH. Use of a stimulating catheter for total knee replacement surgery:preliminary results. Br J Anaesth, 2005, 95(2):250-254.
17.	Skinner HB. Multimodal acute pain management. Am J Orthop, 2004, 33(suppl 5):5-9.
18.	De Cosmo G, Aceto P, Gualtieri E, et al. Analgesia in thoracic surgery:review. Minerva Anestesiol, 2009, 75(6):393-400.
19.	Fassoulaki A, Triga A, Melemeni A, et al. Multimodal analgesia with gabapentin and local anesthetics prevents acute and chronic pain after breast surgery for cancer. Anesth Analg, 2005, 101(5):1427-1432.
20.	Bilir A, Gulec S, Erkan A, et al. Epidural Magnesium reduces post-operative analgesic requirement. Br J Anaesth, 2007, 98(4):519-523.
21.	Reuben SS, Ekman EF, Charron D. Evaluating the analgesic efficacy of administering celecoxib as a component of multimodal analgesia for outpatient anterior cruciate ligament Reconstruction surgery. Anesth Analg, 2007, 105(1):222-227.
22.	李廷江, 孙文孔.围手术期超前平衡镇痛用于肛肠手术止痛的临床效果观察.中国普外基础与临床杂志, 2012, 19(2):217-219.

1. Sun E, Dexter F, Macario A. Can an acute pain service be cost-effec-tive? Anesth Analg, 2010, 111(4):841-844.
2. Baliki MN, Chialvo DR, Geha PY, et al. Chronic pain and the emotional brain:specific brain activity associated with spontaneous fluctuations of intensity of chronic back pain. J Neurosci, 2006, 26(47):12165-12173.
3. 中华医学会外科学分会结直肠肛门外科学组, 中华中医药学会肛肠病专业委员会, 中国中西医结合学会结直肠肛门病专业委员会.痔临床诊治指南(2006版).中华胃肠外科杂志, 2006, 9(5):461-463.
4. 汪明.肛门直肠病手术后尿潴留的原因预防及治疗.中国肛肠病杂志, 2004, 24(3):35.
5. Kerr DR, Kohan L. Local infiltration analgesia:a technique for the control of acute postoperative pain following knee and hip surgery:a case study of 325 patients. Acta Onhop, 2008, 79(2):174-183.
6. 杨建芳, 王彦君, 常淑娴.肛肠病患者术后疼痛的原因分析及处理.中国交通医学杂志, 2006, 20(1):95-97.
7. 王军省, 潘芳杰.长效止痛剂用于肛肠病术后疼痛的临床研究.中华实用中西医杂志, 2005, 18(19):1129-1130.
8. Loeser JD, Treede RD. The Kyoto protocol of IASP basic pain terminology. Pain, 2008, 137(3):473-477.
9. Fillingim RB, King CD, Ribeiro-Dasilva MC, et al. Sex, gender, and pain:a review of recent clinical and experimental findings. J Pain, 2009, 10(5):447-485.
10. Crile GW, Lower WE. Anoci-association. Philadelphia:Saunders, 1914:223-225.
11. Woolf CJ. Evidence for a central component of post-injury pain hypersensitivity. Nature, 1984, 306(5944):686-688.
12. Reuben SS, Buvanendran A. Preventing the development of chronic pain after orthopaedic surgery with preventive multimodal analgesic techniques. J Bone Joint Surg Am, 2007, 89(6):1343-1358.
13. McCartney CJ, Sinha A, Katz J. A qualitative systematic review of the role of N-methyl-D-aspartate receptor antagonists in preventive analgesia. Anesth Analg, 2004, 98(5):1385-1400.
14. Bong CL, Samuel M, Ng JM, et al. Effects of preemptive epidural an-algesia on post-thoracotomy pain. J Cardiothorac Vasc Anesth, 2005, 19(6):786-793.
15. Møiniche S, Kehlet H, Dahl JB. A qualitative and quantitative systematic review of preemptive analgesia for postoperative pain relief:the role of timing of analgesia. Anesthesiology, 2002, 96(3):725-741.
16. Jack NM, Liem EB, Vonhögen LH. Use of a stimulating catheter for total knee replacement surgery:preliminary results. Br J Anaesth, 2005, 95(2):250-254.
17. Skinner HB. Multimodal acute pain management. Am J Orthop, 2004, 33(suppl 5):5-9.
18. De Cosmo G, Aceto P, Gualtieri E, et al. Analgesia in thoracic surgery:review. Minerva Anestesiol, 2009, 75(6):393-400.
19. Fassoulaki A, Triga A, Melemeni A, et al. Multimodal analgesia with gabapentin and local anesthetics prevents acute and chronic pain after breast surgery for cancer. Anesth Analg, 2005, 101(5):1427-1432.
20. Bilir A, Gulec S, Erkan A, et al. Epidural Magnesium reduces post-operative analgesic requirement. Br J Anaesth, 2007, 98(4):519-523.
21. Reuben SS, Ekman EF, Charron D. Evaluating the analgesic efficacy of administering celecoxib as a component of multimodal analgesia for outpatient anterior cruciate ligament Reconstruction surgery. Anesth Analg, 2007, 105(1):222-227.
22. 李廷江, 孙文孔.围手术期超前平衡镇痛用于肛肠手术止痛的临床效果观察.中国普外基础与临床杂志, 2012, 19(2):217-219.

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超前平衡镇痛在混合痔术中的临床应用

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