目标:如介绍,用于回肠造口术逆转的多模式疼痛管理束可被考虑减少术后疼痛和住院时间。这项研究的目的是评估围手术期多模式疼痛束回肠造口术的临床疗效。
方法:分析2017年4月至2020年3月直肠癌术后回肠造口术逆转患者的病历。67例患者接受了回肠造口术逆转的多模式疼痛束协议(A组),41例患者接受了常规疼痛管理的回肠造口术闭合(B组)。
结果:基线特征,包括年龄,性别,身体质量指数,美国麻醉医师学会分类,糖尿病,吸烟史,两组之间没有显着差异。A组术后第1天疼痛评分显著降低(视觉模拟量表,2.6±1.3vs.3.2±1.2;P=0.013)。A组阿片类药物的总体消费量明显少于B组(9.7±9.5vs.21.2±8.8,P<0.001)。A组住院时间明显缩短(2.3±1.5天vs.4.1±1.5天,P<0.001)。术后并发症发生率组间差异无统计学意义。
结论:回肠造口逆转的多模式疼痛方案可以减轻术后疼痛,与传统疼痛管理相比,阿片类药物的使用和住院时间。
OBJECTIVE: As introduced, multimodal pain management bundle for ileostomy reversal may be considered to reduce postoperative pain and hospital stay. The aim of this study was to evaluate clinical efficacy of perioperative multimodal pain bundle for ileostomy.
METHODS: Medical records of patients who underwent ileostomy reversal after rectal cancer surgery from April 2017 to March 2020 were analyzed. Sixty-seven patients received multimodal pain bundle protocol with ileostomy reversal (group A) and 41 patients underwent closure of ileostomy with conventional pain management (group B).
RESULTS: Baseline characteristics, including age, sex, body mass index, American Society of Anesthesiologists classification, diabetes mellitus, and smoking history, were not significantly different between the groups. The pain score on postoperative day 1 was significant lower in group A (visual analog scale, 2.6 ± 1.3 vs. 3.2 ± 1.2; P = 0.013). Overall consumption of opioid in group A was significant less than group B (9.7 ± 9.5 vs. 21.2 ± 8.8, P < 0.001). Hospital stay was significantly shorter in group A (2.3 ± 1.5 days vs. 4.1 ± 1.5 days, P < 0.001). There were no significant differences between the groups in postoperative complication rate.
CONCLUSIONS: Multimodal pain protocol for ileostomy reversal could reduce postoperative pain, usage of opioid and hospital stay compared to conventional pain management.