围手术期神经阻滞可减少正颌手术后的急性术后疼痛。
Perioperative Nerve Blockade Reduces Acute Postoperative Pain after Orthognathic Surgery.
机构信息
Division of Dental Anesthesiology, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry, Sakado, Japan.
Center for Neuroplasticity and Pain, SMI, Department of Health Science and Technology, School of Medicine, Aalborg University, Aalborg, Denmark.
出版信息
Pain Res Manag. 2023 Dec 19;2023:7306133. doi: 10.1155/2023/7306133. eCollection 2023.
BACKGROUND
The role of perioperative pain management is not only to reduce acute postoperative pain (POP) but also to prevent chronic POP. It would be important to know the usefulness of nerve blockade for perioperative management. However, it has not been extensively studied in orofacial surgery. The objective of the study was to investigate whether perioperative nerve blockade reduces acute POP after orthognathic surgery.
METHODS
Patients scheduled for orthognathic surgery were retrospectively reviewed ("preblock group": the nerve blockade was performed before emergence from general anesthesia, and "no preblock group": the nerve blockade was not performed before emergence from general anesthesia). The visual analog scale (VAS; 0-100 mm)-POP intensity, the VAS-POP areas under the curves (VASAUCs (mm × day)) in addition to VASAUCs for postoperative hours 6 (VASAUC_6), 12 (VASAUC_12), 18 (VASAUC_18), and 24 (VASAUC_24), the analgesic requirement period (day), and the number of days with pain (day) were analyzed. Data are presented as median (interquartile range) values.
RESULTS
Fifty-six patients (preblock group, 22; no preblock group, 34) were included (21 males, 35 females; age: 22.0 [21.0-28.0] years). VASAUC_6, VASAUC_12, VASAUC_18, and VASAUC_24 in the preblock group were significantly smaller than those in the no preblock group (3.5 [2.0-7.2] vs. 7.4 [5.1-10.0], = 0.0007; 9.5 [6.4-13.7] vs. 15.0 [7.2-22.9], = 0.042; 15.7 [10.3-23.1] vs. 29.3 [18.9-37.2], = 0.0002; and 17.6 [12.7-27.2] vs. 39.5 [22.9-46.9], = 0.001, respectively). There were no significant differences between the 2 groups in VASAUC, the analgesic requirement period, and the number of days with pain ( > 0.05).
CONCLUSIONS
Perioperative nerve blockade reduces POP after orthognathic surgery, especially for the acute postoperative period.
背景
围手术期疼痛管理的作用不仅在于减轻急性术后疼痛（POP），还在于预防慢性 POP。了解神经阻滞在围手术期管理中的作用非常重要。然而，它在口腔颌面外科中尚未得到广泛研究。本研究的目的是探讨围手术期神经阻滞是否能减少正颌手术后的急性 POP。
方法
回顾性分析接受正颌手术的患者（“预阻滞组”：在全身麻醉苏醒前进行神经阻滞，“无预阻滞组”：在全身麻醉苏醒前不进行神经阻滞）。采用视觉模拟评分（VAS；0-100mm）评估术后即刻 POP 强度，VAS-POP 曲线下面积（VASAUCs（mm×天）），术后 6 小时（VASAUC_6）、12 小时（VASAUC_12）、18 小时（VASAUC_18）和 24 小时（VASAUC_24）的 VASAUCs、镇痛需求期（天）和疼痛天数（天）。数据以中位数（四分位距）表示。
结果
共纳入 56 例患者（预阻滞组 22 例，无预阻滞组 34 例；男 21 例，女 35 例；年龄 22.0[21.0-28.0]岁）。预阻滞组的 VASAUC_6、VASAUC_12、VASAUC_18 和 VASAUC_24 明显小于无预阻滞组（3.5[2.0-7.2]比 7.4[5.1-10.0]，=0.0007；9.5[6.4-13.7]比 15.0[7.2-22.9]，=0.042；15.7[10.3-23.1]比 29.3[18.9-37.2]，=0.0002；和 17.6[12.7-27.2]比 39.5[22.9-46.9]，=0.001，分别）。两组 VASAUC、镇痛需求期和疼痛天数无显著差异（>0.05）。
结论
围手术期神经阻滞可减少正颌手术后的 POP，特别是术后早期。
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