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Clinical Translational Gastro: 利多卡因加双氯芬酸局部镇痛可减轻肛肠手术中的疼痛

2018-11-24 MedSci MedSci原创

有超过50%良性肛门直肠手术(BARS)的患者,特别是痔切除术,会有中度和重度术后疼痛,本研究的目的是评估含有利多卡因加双氯芬酸(CLIFE1)的局部制剂与利多卡因(CLIFE2)相比是否可以增加止痛效果,并进行安全性评估。

背景及目的
有超过50%良性肛门直肠手术(BARS)的患者,特别是痔切除术,会有中度和重度术后疼痛,本研究的目的是评估含有利多卡因加双氯芬酸(CLIFE1)的局部制剂与利多卡因(CLIFE2)相比是否可以增加止痛效果,并进行安全性评估。

方法
这是一项多中心,随机双盲,对照研究。接受BARS(痔疮,肛瘘和肛裂)的患者在手术结束时以1:1的比例随机分组接受给予CLIFE1(n= 60)或CLIFE2(n= 60)肛肠局部治疗,治疗方案均为术后前每12小时一次,第四至第六天为每天一次。主要结果是局部治疗后疼痛减少的平均值,这由患者自身用视觉模拟评分(VAS)测量。

结果
在150例选择接受BARS治疗的患者中,120例患者的结果显示CLIFE1局部治疗后疼痛减轻(7.47±13.09)此结果优于CLIFE2(4.38±6.75)治疗方案,差异为-3.21 95%CI(-5.75; -0.68,p= 0.008),35%接受良性肛肠手术的患者术后疼痛(≥9mm,VAS)明显减少,而只接受利多卡因治疗的患者为18.33%。

结论
在BARS中,CLIFE1局部治疗显示出比CLIFE2更好的镇痛效果。因此更推荐利多卡因加双氯芬酸局部镇痛。

原始出处:

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    2019-09-22 bsmagic9140
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    2019-04-28 许安
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  5. 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  6. 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  7. 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encryptionId=a5404e589d7, topicName=局部)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d14c2562456, createdName=chg122, createdTime=Mon Nov 26 11:40:00 CST 2018, time=2018-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1507643, encodeId=66bc150e64353, content=<a href='/topic/show?id=8764484014' target=_blank style='color:#2F92EE;'>#clinical#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4840, encryptionId=8764484014, topicName=clinical)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1ee59933733, createdName=zll0628, createdTime=Mon Nov 26 11:40:00 CST 2018, time=2018-11-26, status=1, ipAttribution=)]
  8. 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encryptionId=a5404e589d7, topicName=局部)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d14c2562456, createdName=chg122, createdTime=Mon Nov 26 11:40:00 CST 2018, time=2018-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1507643, encodeId=66bc150e64353, content=<a href='/topic/show?id=8764484014' target=_blank style='color:#2F92EE;'>#clinical#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4840, encryptionId=8764484014, topicName=clinical)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1ee59933733, createdName=zll0628, createdTime=Mon Nov 26 11:40:00 CST 2018, time=2018-11-26, status=1, ipAttribution=)]
    2018-11-26 zhaojie88
  9. 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encryptionId=a5404e589d7, topicName=局部)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d14c2562456, createdName=chg122, createdTime=Mon Nov 26 11:40:00 CST 2018, time=2018-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1507643, encodeId=66bc150e64353, content=<a href='/topic/show?id=8764484014' target=_blank style='color:#2F92EE;'>#clinical#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4840, encryptionId=8764484014, topicName=clinical)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=1ee59933733, createdName=zll0628, createdTime=Mon Nov 26 11:40:00 CST 2018, time=2018-11-26, status=1, ipAttribution=)]
    2018-11-26 chg122
  10. 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    2018-11-26 zll0628

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