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題名 | Local Supplementation of Ketoprofen Reduces the Incidence of Low Back Pain after Lumbar Epidural Anesthesia=局部麻醉加入博易寧(Ketoprofen)可以降低腰椎硬脊膜外麻醉後下背痛的發生率 |
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作者 | 謝敬儒; 許汝寧; 余振翔; 劉偉明; 伍乙棠; 王永良; | 書刊名 | 長庚醫學 |
卷期 | 22:3 1999.09[民88.09] |
頁次 | 頁439-444 |
分類號 | 416.54 |
關鍵詞 | 非類固醇消炎止痛劑; 硬脊膜外麻醉; 下背痛; 痔瘡切除手術; Nonsteroidal anti-inflammatory drug; Epidural anesthesia; Backache; Hemorrhoidectomy; |
語文 | 英文(English) |
中文摘要 | 背景:施行硬脊膜外半身麻醉後,病人發生下背痛相當常見。已有一些方式證實 可以減少硬脊膜外麻醉後的下背痛,包括區域阻斷術(field block),或在硬脊膜外麻醉劑中加 入類固醇等方式。本篇則探討在施行硬脊膜外麻醉下之前的局部麻醉劑加入脂溶性非類固醇 消炎止痛劑是否可減少硬脊膜外麻醉後的下背痛,並探討及作用機制。 方法:1000位要進行痔瘡切除術的病患,隨機分為2組,實驗組患者在施行硬脊膜外 麻醉之前的局部麻醉劑中加入小劑量的親脂性非類固醇消炎止痛劑博易寧(ketoprofen),而對 照組則沒有加ketoprofen,之後進行硬脊膜外麻醉及痔瘡切除術。術後24、48及72小時及 術前分別以視覺疼痛量表(visual analog scale)對病人作下背痛的訪視。如果病人術後下背痛 的疼痛量表指數比術前大,則視為有硬脊膜外麻醉後的下背痛。 結果:實驗組病人發生硬脊膜外麻醉下背痛的比率,在術後24、48及72小時分別是 9.8%、4.6%及1.8%,皆比對照組患者(22.8%、17.4%及9.2%)顯著來得高。另外,進行硬脊 膜外麻醉的進針次數也和術後下背痛的發生率有顯著相關。 結論:局部麻醉中加入脂溶性非類固醇止痛劑ketoprofen,可以減少硬脊膜外麻醉後下 背痛的發生率。 |
英文摘要 | Background: Backache is a common postoperative complaint after lumbar epidural anesthesia. Our study was aimed to compare the effect of the local addition of ketoprofen on the incidence of postepidural backache after nonobstetric surgery. Methods: One thousand patients scheduled for hemorrhoidectomy were randomly given 4 ml of 1% lidocaine with ketoprofen 1:400 (ketoprofen group) or without ketoprofen (control group) for local skin infiltration prior to epidural needle placement. Each of them received a single epidural injection of 25ml 2% lidocaine with epinephrine 1:200000, and was interviewed 24,48, and 72 hours postoperatively using a standard visual analog scale (VAS) for evaluation of postepidural backache. Results: The incidence of postepidural backache in the ketoprofen-group patients for the 3 days was 9.8%, 4.6%, and 1.8%. all rates which were significantly less than those observed in the control- group patients (22.8%, 17.4%, and 9.2%, p<0.001). There was also a significant association between postepidural backache and multiple attempts at epidural needle insertion. Conclusion: In summary, the local addition of ketoprofen reduced the incidence and severity of postepidural backche. |
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