Characteristics and prediction of early pain after laparoscopic cholecystectomy
Characteristics and prediction of early pain after laparoscopic cholecystectomy
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DOI：
10.1016/s0304-3959(00)00406-1
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发表时间：
2001-02-15
期刊：
影响因子：
7.4
通讯作者：
Kehlet, H
中科院分区：
文献类型：
--
作者：
Bisgaard, T;Klarskov, B;Kehlet, H
小规模的研究表明，腹腔镜胆囊切除术后早期疼痛的个体差异很大，强调需要改善镇痛治疗和有效的预测。我们前瞻性研究了150例连续接受无并发症腹腔镜胆囊切除术患者术前冰水伤害性刺激（冷压试验）、神经质、消化不良、胆道症状病史、术中因素和dt人口统计学信息之间的关系，以了解其对术后早期疼痛的影响。在术后第一周，患者在视觉模拟量表和口头评定量表上记录总体疼痛、切口疼痛、内脏疼痛和肩部疼痛，并记录每日镇痛需求。在术后第一周，总体疼痛表现出明显的个体间差异。与内脏痛相比，切口痛在发病率和强度上占主导地位，内脏痛反过来又在肩部疼痛上占主导地位。在多变量分析模型中，术前神经质、对冷压诱发疼痛的敏感性和年龄被确定为术后早期疼痛的独立危险因素。我们的研究结果表明，腹腔镜胆囊切除术后的镇痛研究应集中在减少切口疼痛。(C)2001年国际疼痛研究协会。出版社：Elsevier Science B.V. All Lights Reserved
Small-scale studies have suggested a, large inter-individual variation in early postoperative pain after laparoscopic cholecystectomy, emphasizing the need for improved analgesic treatment and valid predictors. We investigated prospectively the association between a preoperative nociceptive stimulus by ice water (cold presser test), neuroticism, dyspepsia, patient history of biliary symptoms, intraoperative factors, and dt demographic information in 150 consecutive patients undergoing uncomplicated laparoscopic cholecystectomy for their influence on early postoperative pain. During the first postoperative week patients registered overall pain, incisional, visceral, and shoulder pain on a visual analogue scale and verbal rating scale, and daily analgesic requirements were noted. Throughout the first postoperative week overall pain showed a pronounced inter-individual variability. Incisional pain dominated in incidence and intensity compared with visceral pain, which in turn dominated over shoulder pain. Tn a multivariate analysis model, preoperative neuroticism, sensitivity to cold pressor-induced pain, and age were identified as independent risk factors for early post postoperative pain. Our results suggest that future analgesic studies after laparoscopic cholecystectomy should focus on reduction of incisional pain. (C) 2001 International Association for the Study of Pain. Published by Elsevier Science B.V. All lights reserved.