背景:皮肤外科手术主要在局部麻醉下进行,然而,很少有研究在局部麻醉下进行广泛或分阶段手术的围手术期疼痛管理。这项研究的目的是评估皮肤科手术期间的疼痛,描述围手术期疼痛管理,并确定影响疼痛感知的因素。
方法:这种前瞻性,单中心研究纳入了2021年4月至12月在局部麻醉下接受皮肤科手术的住院患者.术前人口统计学数据,一份疼痛问卷,和四个心理测量问卷(PCS,LOT-R,SFQ,收集PHQ-9)。记录前24小时的术后疼痛和镇痛药使用情况。
结果:共120例患者(共191例干预)被纳入研究。据报道,平均术后疼痛非常低(NRS<2)。发现术前疼痛和预期的术后疼痛可预测术后疼痛。灾难化和术前焦虑之间有很强的相关性(r=0.65),抑郁和术前焦虑之间有中等相关性(r=0.46)。
结论:局部麻醉下的皮肤手术通常被认为是无痛的。在术前咨询和评估期间,应该注意害怕手术的患者,报告疼痛,或者预测术后疼痛,因为他们经历术后疼痛的风险增加。
BACKGROUND: Dermatosurgical procedures are predominantly performed under local anesthesia, yet there are few studies on perioperative pain management for extensive or staged procedures under local anesthesia. The purpose of this study was to assess pain during dermatologic surgery, describe perioperative pain management, and identify factors that influence pain perception.
METHODS: This prospective, monocentric study included inpatients undergoing dermatologic surgery under local anesthesia from April to December 2021. Preoperative demographic data, a pain questionnaire, and four psychometric questionnaires (PCS, LOT-R, SFQ, PHQ-9) were collected. Postoperative pain and analgesic use during the first 24 hours were recorded.
RESULTS: A total of 120 patients (with a total of 191 interventions) were included in the study. Mean postoperative pain was reported to be very low (NRS < 2). Preoperative pain and expected postoperative pain were found to be predictive of postoperative pain. There was a strong correlation between catastrophizing and preoperative anxiety (r = 0.65) and a moderate correlation between depression and preoperative anxiety (r = 0.46).
CONCLUSIONS: Dermatologic surgery under local anesthesia is generally considered painless. During preoperative counseling and assessment, attention should be paid to patients who fear surgery, report pain, or anticipate postoperative pain, as they have an increased risk of experiencing postoperative pain.