Comparison of predicted and perceived pain from epidural and spinal puncture in patients undergoing elective caesarean section
Comparison of predicted and perceived pain from epidural and spinal puncture in patients undergoing elective caesarean section
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DOI：
10.1177/0310057x1103900418
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发表时间：
2011-07-01
影响因子：
1.5
通讯作者：
Tsuneyoshi, I.
中科院分区：
文献类型：
--
作者：
Yano, T.;Iwasaki, T.;Tsuneyoshi, I.
在硬膜外和/或脊柱穿刺之前患者预期的疼痛强度是不确定的。本研究的主要目的是识别和比较接受硬膜外手术和脊柱手术的患者预测和感知的疼痛强度。在筛选相关排除标准后，50 名在腰硬联合麻醉（双节段技术）下接受选择性剖腹产的妇女被纳入该研究。硬膜外穿刺在进针前进行浸润麻醉，但脊柱穿刺不进行。在硬膜外和脊柱穿刺之前（预测疼痛）和之后（感知疼痛）使用 100 毫米视觉模拟疼痛量表进行疼痛评估。硬膜外和脊柱插入的预测疼痛（硬膜外 60.6 +/- 20.5 mm，脊柱：55.1 +/- 24 mm）显着高于感知疼痛（硬膜外 36.3 +/- 20 mm，脊柱 46.1 +/- 23.2 mm）（硬膜外 P < 0.001，脊柱 P=0.031）。计划在腰硬联合麻醉下进行择期剖腹产手术的患者预计疼痛强度比手术过程中感知到的疼痛强度高 1.2 至 1.7 倍。应告知患者，区域麻醉（尤其是硬膜外麻醉）手术通常比患者预期的疼痛要轻。
The intensity of pain expected by patients before an epidural and/or a spinal puncture is uncertain. The main purpose of this study was to identify and compare the intensity of pain predicted and perceived by patients having an epidural and a spinal procedure. After screening for relevant exclusion criteria, 50 women who were undergoing elective caesarean section under combined spinal-epidural anaesthesia (double-segment technique) were enrolled in the study. Infiltration anaesthesia prior to needle insertion was performed for the epidural but not the spinal puncture. Pain assessments, using a 100 mm visual analogue pain scale, were made before (predicted pain) and after (perceived pain) the epidural and the spinal puncture. Predicted pain for epidural and spinal insertion (epidural 60.6 +/- 20.5 mm, spinal: 55.1 +/- 24 mm) was significantly higher than the pain perceived (epidural 36.3 +/- 20 mm, spinal 46.1 +/- 23.2 mm) (epidural P < 0.001, spinal P=0.031). Patients who were scheduled for an elective caesarean section under combined spinal-epidural anaesthesia predicted 1.2- to 1.7-fold stronger pain intensity than they perceived during the procedure. Patients should be informed that a regional anaesthetic, especially epidural, procedure is often less painful than the patient's expectation.