Factors that affect intravenous patient-controlled analgesia for postoperative pain following orthognathic surgery for mandibular prognathism.
Factors that affect intravenous patient-controlled analgesia for postoperative pain following orthognathic surgery for mandibular prognathism.
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DOI：
10.1371/journal.pone.0098548
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Fukuda K
中科院分区：
文献类型：
--
作者：
Aoki Y;Yoshida K;Nishizawa D;Kasai S;Ichinohe T;Ikeda K;Fukuda K
先前发现术后疼痛和镇痛药使用量的预测因素包括术前疼痛、焦虑、年龄、手术类型和基因型，但术中因素是否能预测术后疼痛仍不清楚。在本研究中，我们利用下颌前突正颌手术患者的静脉自控镇痛记录，研究了芬太尼使用量的时间进程，并分析了麻醉方法、手术方法以及性别对该时间进程的影响。发现芬太尼给药的时间进程存在显著差异（P<0.001）。男性和女性之间芬太尼给药的时间进程无显著差异（P = 0.653），时间进程与性别之间无交互作用（P = 0.567）。在不同麻醉方法之间，如芬太尼诱导后芬太尼维持、芬太尼诱导后瑞芬太尼维持以及瑞芬太尼诱导后瑞芬太尼维持，芬太尼给药的时间进程无显著差异（P = 0.512），但观察到时间进程与麻醉方法之间存在交互作用（P = 0.004）。在手术方法之间，如双侧下颌升支矢状劈开截骨术（BSSRO）和BSSRO联合Le Fort I型截骨术（双颌手术），芬太尼给药的时间进程存在显著差异（P = 0.008），时间进程与手术方法之间无交互作用（P = 0.535）。与双颌手术相关的术后24小时总使用量显著高于BSSRO（P = 0.008）。目前的结果表明，三组麻醉方法之间以及两组手术方法之间的给药模式和24小时总使用量分别存在差异。尽管有必要对患者自控镇痛模式和使用量进行更多研究，但本研究将有助于充分缓解个体患者的术后疼痛。
The predictors of postoperative pain and analgesic consumption were previously found to include preoperative pain, anxiety, age, type of surgery, and genotype, but remaining unclear was whether intraoperative factors could predict postoperative pain. In the present study, we investigated the time-course of fentanyl consumption using intravenous patient-controlled analgesia records from patients who underwent orthognathic surgery for mandibular prognathism and analyzed the influence of anesthesia methods and surgical methods together with sex on the time course. A significant difference in the time course of fentanyl administration was found (P<0.001). No significant difference in the time course of fentanyl administration was found between males and females (P = 0.653), with no interaction between time course and sex (P = 0.567). No significant difference in the time course of fentanyl administration was found among anesthesia methods, such as fentanyl induction followed by fentanyl maintenance, fentanyl induction followed by remifentanil maintenance, and remifentanil induction followed by remifentanil maintenance (P = 0.512), but an interaction between time course and anesthesia method was observed (P = 0.004). A significant difference in the time course of fentanyl administration was found between surgical methods, such as bilateral mandibular sagittal split ramus osteotomy (BSSRO) and BSSRO combined with Le Fort I osteotomy (bimaxillary; P = 0.008), with no interaction between time course and surgical method (P = 0.535). Total postoperative 24 h consumption associated with the bimaxillary procedure was significantly higher than with BSSRO (P = 0.008). The present results indicate that administration patterns and total 24 h consumption were different among the three groups of anesthesia methods and between the two groups of surgical methods, respectively. Although more research on patient-controlled analgesia patterns and consumption is necessary, the present study will contribute to adequately relieving individual patients from postoperative pain.
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影响因子：
11
作者：
Nishizawa, D.;Fukuda, K.;Kasai, S.;Hasegawa, J.;Aoki, Y.;Nishi, A.;Saita, N.;Koukita, Y.;Nagashima, M.;Katoh, R.;Satoh, Y.;Tagami, M.;Higuchi, S.;Ujike, H.;Ozaki, N.;Inada, T.;Iwata, N.;Sora, I.;Iyo, M.;Kondo, N.;Won, M-J;Naruse, N.;Uehara-Aoyama, K.;Itokawa, M.;Koga, M.;Arinami, T.;Kaneko, Y.;Hayashida, M.;Ikeda, K.
通讯作者：
Ikeda, K.
影响因子：
168.9
作者：
Weiser, Thomas G.;Regenbogen, Scott E.;Gawande, Atul A.
通讯作者：
Gawande, Atul A.
影响因子：
7.4
作者：
Fukuda, Kenichi;Hayashida, Masakazu;Ikeda, Kazutaka
通讯作者：
Ikeda, Kazutaka
影响因子：
--
作者：
Chegini, Soudeh;Johnston, Kevin D;Dhariwal, Daljit K
通讯作者：
Dhariwal, Daljit K
影响因子：
2.2
作者：
de Santana-Santos, Thiago;de Souza-Santos, Jadson-Alipio-Santana;Gomes, Ana-Claudia-Amorim
通讯作者：
Gomes, Ana-Claudia-Amorim