The purpose of this randomized, double-blind, clinical trial was to determine whether intraoperative, intramuscular (IM) injections of meperidine or ketorolac would improve postoperative pain relief in patients undergoing elective laparoscopic cholecystectomy. A total of 125 patients were entered into five study groups1) (N = 23) control placebo; 2) (N = 31) meperidine 100 mg IM intraoperative preprocedure; 3) (N = 20) meperidine 100 mg IM intraoperative postprocedure; 4) (N = 25) ketorolac tromethamine 60 mg IM intraoperative preprocedure; 5) (N = 26) ketorolac tromethamine 60 mg IM postprocedure. All groups were analyzed by comparing the amount of pain medication received in the recovery room, the time until first oral pain medication was requested, the overall amount of pain medication used in the first 24 hours, the percent requiring IM medication, and the pain score ratings from each group. There was decreased pain medication usage in the recovery room in all groups compared to control (P < 0.05). Group 4 had a longer painfree interval than meperidine groups or control. Both Groups 4 and 5 had decreased postoperative narcotic usage. Finally, the analogue pain scores showed that both ketorolac groups had significantly less postoperative pain compared to control, whereas the meperidine groups showed no improvement in postoperative pain relief. Intraoperative ketorolac given preprocedure or postprocedure significantly improved postoperative pain management and facilitated the transition to oral pain medication.

译文

这项随机,双盲,临床试验的目的是确定术中,肌肉 (IM) 注射哌替啶或酮咯酸是否可以改善接受选择性腹腔镜胆囊切除术的患者的术后疼痛缓解。共有125例患者进入五个研究组1 (N = 23) 对照安慰剂; 2) (N = 31) 哌替啶100 mg IM术中术前; 3) (N = 20) 哌替啶100 mg IM术中术后; 4) (N = 25) 酮洛酸氨丁三醇60 mg IM术中术前; 5) (N = 26) 酮洛酸氨丁三醇60 mg IM术后。通过比较恢复室中接受的止痛药量,要求首次口服止痛药的时间,最初24小时内使用的止痛药总量,需要IM药物的百分比以及每组的疼痛评分来分析所有组。与对照组相比,所有组在恢复室的止痛药使用量均减少 (P <0.05)。第4组的无痛间隔时间比哌替啶组或对照组更长。第4组和第5组术后麻醉药物使用量均减少。最后,模拟疼痛评分显示,与对照组相比,酮咯酸组的术后疼痛明显减少,而哌替啶组的术后疼痛缓解没有改善。术中给予酮咯酸术前或术后可显着改善术后疼痛管理,并促进了口服止痛药的过渡。

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