Preoperative and postoperative analgesic techniques in the treatment of patients undergoing transabdominal hysterectomy: a preliminary randomized trial

BMC Anesthesiology

Research Article

Ruiping Xue¹  Zhen Wu¹  Lai-you Wen¹  Jian-qing Chen¹  Yong-ming Hu¹  Jian-zhong Miao¹ 

[1]Department of Anesthesiology, The Affiliated Jiangyin Hospital of Nantong University, 163 Shoushan Road, Jiangyin, Jiangsu Province, China

关键词: Pre-emptive analgesia;    Multimodal;    Transabdominal hysterectomy;    Stress response;    Inflammatory cytokines;   

DOI  :  10.1186/s12871-015-0046-4

 received in 2014-08-27, accepted in 2015-04-21,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundAlthough pre-emptive analgesia is commonly used for the management of postoperative pain in developed countries, no defined protocol has been carried out and widely practiced, especially in transabdominal hysterectomy. Keeping this in mind the present study aimed to investigate the effects of multimodal pre-emptive analgesia on pain management, stress response and inflammatory factors of patients undergoing transabdominal hysterectomy to find an optimized way of pre-emptive analgesia.MethodsOne hundred patients undergoing abdominal hysterectomy were randomly divided into four groups (Trial registration: ChiCTR-IPR-15005848). Group P1 was given intravenous flurbiprofen and epidural fentanyl + ketamine before surgery; Group P2 received intravenous flurbiprofen before surgery and epidural fentanyl + ketamine after surgery; Group P3 was given epidural fentanyl + ketamine before surgery and intravenous flurbiprofen after surgery; Patients in Group C received normal saline treatment.ResultsCompared with control group, the first time to request additional analgesics after surgery were significantly later (P <0.05), 24 h dosage of analgesia were significantly less (P <0.05), VAS score at all time periods after surgery were significantly lower (P <0.05) in Group P1, P2, or P3. At 12 h or 24 h after surgery, VAS score in Group P1 was significantly lower than that in group P2 or P3 (P <0.05, P <0.05). No significant adverse effects were found among the groups (P > 0.05). At 1 or 2 days after surgery, the levels of cortisol, glucose, and IL-6, TNF-α in group P1, P2, and P3 were significantly lower than those in group C (P < 0.05); while, the levels in group P2, P3 were significantly lower than those in group P1 (P < 0.05).ConclusionMultimodal pre-emptive analgesia could significantly lower VAS score, inhibit stress response, and reduce inflammatory response in patients undergoing transabdominal hysterectomy, which can be a rational strategy for pain control in future.Trial registrationChiCTR-IPR-15005848 on January 17, 2015.

【 授权许可】

CC BY   
© Chen et al. 2015

【 图 表 】

12864_2016_2443_Article_IEq12.gif