Search  in
Original Articles
NUMBER 3-4 YEAR 2011
The Role of Multimodal Analgesia in Patients With Tubal Pathology Treated by Laparoscopic Surgery
1 Department of Anesthesiology and Intensive Care, University of Medicine and Pharmacy, Iasi,
2 Department of Surgery, Municipal Hospital, Moinesti,
3 Department of Obstetrics and Gynecology, Elena Doamna Hospital, Iasi

Correspondence to:
Laura Gavril, Department of Anesthesiology and Intensive Care, University of Medicine and Pharmacy, Iasi
Email: cotirlet_laura@yahoo.com
REZUMAT
Obiectiv: Scopul lucrarii este de a evidentia avantajele analgeziei multimodale in tratamentul durerii acute postoperatorii la pacientele operate laparoscopic pentru patologia tubara si consecintele acestei terapii asupra evolutiei postoperatorii, comparativ cu metoda clasica de tratament a durerii postoperatorii. Material si metoda: Studiul este prospectiv si include 44 de paciente, impartite aleatoriu in 2 grupe: lotul de studiu, 22 paciente, la care s-a practicat o schema de analgezie multimodala (administrarea i.v, inaintea inductiei anesteziei, de inhibitor-COX2, parecoxib sodic; infiltrarea de levobupivacaina la nivelul plasarii fiecarui trocar, preincizional si instilarea intraperitoneala de levobupivacaina la inceputul si la sfarsitul interventiei) si lotul martor, 22 paciente, la care s-a practicat o schema de analgezie “la cerere” (nu s-au administrat substante analgetice non-opioide pre- sau intraoperator). Evaluarea intensitatii durerii postoperatorii s-a efectuat la ambele loturi atat in repaus-static cat si la mobilizare usoara- dinamic, initial la 4 ore apoi la 8, 12 si 24 ore. Rezultate: In primele 12 ore postoperator, scorul durerii in repaus la lotul de studiu a fost de 0,04±0,21 comparativ cu 3,22±1,19 la lotul martor, iar scorul durerii la mobilizare a fost de 0,22±0,61 la lotul de studiu comparativ cu 5,4±1,22 la lotul martor. La pacientele din lotul de studiu incidenta greturilor si varsaturilor a fost mai scazuta, mobilizarea si externarea din spital a fost mai rapida. Concluzii: La pacientele din lotul de studiu s-a constatat o buna analgezie postoperatorie, evidentiata prin scoruri ale durerii mici pe scara vizuala analoga (SVA), atat in repaus la pat, cat si la mobilizarea usoara.

ABSTRACT
Objective: The aim of the study is to highlight the benefits of multimodal analgesia in the treatment of postoperative pain in patients with tubal pathology operated by laparoscopic surgery compared to classical postoperative pain management. Material and method: This study is a prospective one and included a number of 44 patients operated by laparoscopic surgery for tubal pathology. The patients were randomly divided into two groups: the study group (22 patients) received pre- and intraoperative multimodal analgesia, which included a COX-2 inhibitor (parecoxib) i.v. before induction of anesthesia, levobupivacaine infiltration before skin incision and intraperitoneal administration of levobupivacaine at the beginning and at the end of the procedure, and the control group (22 patients) had general anesthesia without any pre- or intraoperative nonopioid analgesic. Evaluation of postoperative pain intensity was performed in both groups, at rest,static, and during mobilization, dynamic, at first at 4 hours and then at 8, 12 and 24 hours. Results: In the first 12 hours postoperatively the mean pain score at rest in the study group was 2,98±0,53 compared to 4,66±1,15 in the control group and the mean pain score during mobilization was 3,81±0,88 in the study group compared to 5,91±1,47 in the control group. Incidence of PONV was lower, mobilization and hospital discharge were faster for patients in the study group. Conclusion: Pre- and intraoperative multimodal management of postoperative pain resulted in lower VAS pain scores at rest and during mobilization compared to classical postoperative pain treatment.


"Victor Babes" Publishing House "Victor Babes" University of Medicine and Pharmacy Romanian Academy of Medical Sciences National Council of Scientific Research in Higher Education (B+) Index Copernicus
Journals Master List
Embase Journal List Timisoara Medical Scientific Association
 
ISSN: 1583-526X (Online Edition)
Copyright © 2002-2017 Timisoara Medical Journal. All rights reserved.