不同因素对耳鼻喉手术术后疼痛的影响
摘要
<正>常见的耳鼻喉头颈外科手术,如扁桃体切除术、鼻中隔成形术、鼻息肉切除术、等离子射频下颚咽成形术等,术中的组织损伤、炎症、神经刺激、肌肉暴露、术后水肿等是导致术后疼痛的主要因素。疼痛无法缓解不但会造成身体动员的推迟,引起并发症,还会造成心理压力及焦虑情绪,从而进一步加重术后疼痛。近年来,临床工作者一直在探索控制耳鼻喉手术术后疼痛的最佳方法。现对不同药物、不同手术方式及术后镇痛泵的应用对耳鼻喉手术术后疼痛影响
引文
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[13]Ju NY,Cui GX,Gao W.Ropivacaine plus dexamethasone infiltration reduces postoperative pain after tonsillectomy and adenoidectomy[J].Int J Pediatr Otorhinolaryngol,2013,77:1881-1885.
[14]Remy C,Marret E,Bonnet F.Effects of acetaminophen on morphine side-effects and consumption after major surgery:meta-analysis of randomized controlled trials[J].Br J Anaesth,2005,94:505-513.
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[18]Cheung CW,Ying CL,Lee LH,et al.An audit of postoperative intravenous patient-controlled analgesia with morphine:evolution over the last decade[J].Eur J Pain,2009,13:464-471.
[2]Shukry M,Kennedy K.Dexmedetomidine as a total intravenous anesthetic in infants[J].Paediatr Anaesth,2007,17:581-583.
[3]Meng QT,Xia ZY,Luo T,et al.Dexmedetomidine reduces emergence agitation after tonsillectomy in children by sevoflurane anesthesia:a case-control study[J].Int J Pediatr Otorhinolaryngol,2012,76:1036-1041.
[4]Erk G,Ornek D,Donmez NF,et al.The use of ketamine or ketamine-midazolam for adenotonsillectomy[J].Int J Pediatr Otorhinolaryngol,2007,71:937-941.
[5]Alzahrani M,Martin F,Bobillier C,et al.Combined local anesthesia and monitored anesthesia care for cochlear implantation[J].Eur Ann Otorhinolaryngol Head Neck Dis,2014,131:261-262.
[6]Naja MZ,El-Rajab M,Kabalan W,et al.Pre-incisional infiltration for pediatric tonsillectomy:a randomized double-blind clinical trial[J].Int J Pediatr Otorhinolaryngol,2005,69:1333-1341.
[7]?zkiris M,Kapusuz Z,Saydam L.Comparison of ropivacaine,bupivacaine and lidocaine in the management of post-tonsillectomy pain[J].Int J Pediatr Otorhinolaryngol,2012,76:1831-1834.
[8]Gemma M,Piccioni LO,Gioia L,et al.Ropivacaine peritonsillar infiltration for analgesia after adenotonsillectomy in children:a randomized,double-blind,placebo-controlled study[J].Ann Otol Rhinol Laryngol,2009,118:227-231.
[9]Kaygusuz I,Susaman N.The effects of dexamethasone,bupivacaine and topical lidocaine spray on pain after tonsillectomy[J].Int J Pediatr Otorhinolaryngol,2003,67:737-742.
[10]Nikanne E,Kokki H,Salo J,et al.Celecoxib and ketoprofen for pain management during tonsillectomy:a placebo-controlled clinical trial[J].Otolaryngol Head Neck Surg,2005,132:287-294.
[11]Kocum AI,Sener M,Caliskan E,et al.Intravenous paracetamol and dipyrone for postoperative analgesia after day-case tonsillectomy in children:a prospective,randomized,double blind,placebo controlled study[J].Braz J Otorhinolaryngol,2013,79:89-94.
[12]Yilmazer C,Sener M,Yilmaz I,et al.Pre-emptive analgesia for removal of nasal packing:A double-blind placebo controlled study[J].Auris Nasus Larynx,2007,34:471-475.
[13]Ju NY,Cui GX,Gao W.Ropivacaine plus dexamethasone infiltration reduces postoperative pain after tonsillectomy and adenoidectomy[J].Int J Pediatr Otorhinolaryngol,2013,77:1881-1885.
[14]Remy C,Marret E,Bonnet F.Effects of acetaminophen on morphine side-effects and consumption after major surgery:meta-analysis of randomized controlled trials[J].Br J Anaesth,2005,94:505-513.
[15]Dolin SJ,Cashman JN,Bland JM.Effectiveness of acute postoperative pain management:I.Evidence from published data[J].Br J Anaesth,2002,89:409-423.
[16]Crews JC.New developments in epidural anesthesia and analgesia[J].Anesthesiol Clin North America,2000,18:251-266.
[17]Hudcova J,Mc Nicol E,Quah C,et al.Patient controlled opioid analgesia versus conventional opioid analgesia for postoperative pain[J].Cochrane Database Syst Rev,2006,4:CD003348.
[18]Cheung CW,Ying CL,Lee LH,et al.An audit of postoperative intravenous patient-controlled analgesia with morphine:evolution over the last decade[J].Eur J Pain,2009,13:464-471.