ABSTRACT
Objective To evaluate musical therapy combined with sufentanil postoperative intravenous analgesia on hemodynamic changes in patient accepted lung cancer operation.Methods Sixty lung cancer surgery patients (ASA Ⅰ-Ⅱ grade) were selected and divided randomly into musical therapy (group M; n =30) and control (group C; n =30).In group M,patients accepted music relaxation training for fifteen minutes before surgery,and music intervention for one hour at 3,7,15,19 hour after surgery.Whereas,in Group C,patients did not listen to any music during the same period.In the intensive care unit,patients were connected to a patient controlled analgesia (PCA) device.The PCA device (sufentanil 2 μg/kg,100 ml saline) was set to deliver a bolus of 2 ml,with a lockout interval of 10 min and background infusion volume of 0.5 ml/h.Hemodynamic changes,the visual analog scale (VAS) and consumption of sufentanil were recorded at the 4th,8th,12th,16th,20th and 24th hour after operation.Results SBP,DBP,HR and VAS of group M were significantly decreased compared to the group C,respectively (P ＜0.05),and significant difference was found in the PCA delivery frequency [group C (30.96 ± 4.00),group M (19.06 ± 3.49),t =12.39,P ＜ 0.01] and postoperative sufentanil consumption[group C (82.65±6.19)μg,group M (52.68 ±7.07)μg,t =20.00,P ＜0.01].Conclusions Musical therapy combined with sufentanil postoperative intravenous analgesia was able to produce better analgesic effect in the treatment of patient accepted lung cancer operation,which decreased postoperative sufentanil consumption and effectively reduced SBP,DBP and HR,and relieved the patient's anxiety.
ABSTRACT
Este trabalho prospectivo, duplo-cego randomizado, avaliou o efeito da analgesia preemptiva do cetoprofeno e do parecoxibe. Sessenta pacientes foram submetidos à cirurgia para remoção de terceiros molares inferiores bilaterais inclusos, sendo operado um lado de cada vez. O paciente foi seu próprio controle. Os pacientes foram separados em dois grupos de 30 pacientes. No grupo parecoxibe, na primeira operação foi usado o parecoxibe ou placebo, endovenoso, 30 minutos antes da cirurgia e imediatamente após a operação foi feita a administração do placebo ou parecoxibe, garantindo ao paciente receber parecoxibe antes ou após a operação. O lado oposto foi operado após duas semanas da primeira cirurgia e o paciente que havia recebido parecoxibe antes e placebo depois da operação recebeu placebo antes e parecoxibe depois da operação e o que havia recebido placebo antes e parecoxibe depois recebeu parecoxibe antes e placebo depois. Nos 30 pacientes do grupo cetoprofeno, o modelo foi o mesmo, substituindo-se apenas o parecoxibe pelo cetoprofeno. O paciente pôde utilizar como medicação resgate a dipirona, sempre que necessário para controlar a dor pós-operatória. Após a operação foi fornecido para todos os pacientes um questionário, contendo a escala analógica visual (EAV), a escala descritiva de dor (EDD) e uma tabela para informar o consumo de medicação resgate. Foi avaliada a dor pós-operatória por meio da EAV, da EDD e pelo consumo de medicação resgate. Não houve diferença estatisticamente relevante quanto a intensidade da dor com o uso do parecoxibe ou do cetoprofeno antes ou depois do procedimento cirúrgico. Ao comparar a analgesia proporcionada pelo cetoprofeno e pelo parecoxibe os resultados mostraram que o parecoxibe administrado antes do procedimento cirúrgico foi mais eficaz do que o cetoprofeno no controle da dor na quarta hora do pós-operatório (p=0,041), mas foi menos eficaz após 24h (p=0,003). Quando se comparou a analgesia proporcionada por esses...
This is a prospective, double-blind randomized, cross over experiment, to evaluate the effect of the preemptive analgesia of ketoprofen and parecoxib. Sixity patients who had gone though surgery for removal of the impacted mandibular bilateral third molar teeth, having one side operated each time, were evaluated. The patients were separated in groups of 30, in the parecoxib group (P). On the first operation parecoxib or placebo were used 30 minutes before the surgery. Immediately after the operation, placebo or parecoxib were administred, so that the patient who had received parecoxib before the operation or after it. The opposite side was operated two weeks after the first surgery and the patients who received parecoxib before and placebo after operation received placebo before and parecoxib after operation and patients who received placebo before and parecoxib after received parecoxib before and placebo after, under the same method. In the group C (n= 30), the model was the same, using ketoprofen instead parecoxib. The patient could use dipyrone as rescue medication, in the event of postoperative pain. A questionnaire was provided to the patient after each surgery, containing a visual analogic scale, a descriptive pain scale and a table to inform the consum of rescue medication. The postoperative pain was evaluated by visual analogic scale, descriptive pain scale and rescue medicine consum. There was no statistically relevant difference as pain intensity with use of parecoxib or ketoprofen before or after the surgical procedure. Comparing ketoprofen analgesia against parecoxib analgesial, the results shown that the administration of parecoxib before the surgical procedure had a major efficacy than ketoprofen in pain control by the fourth hour post operatory (p=0,041), but was less efficient after 24 hours (p=0,003). When comparing the analgesic effect of both drugs after the operation, parecoxib was more effective than ketoprofen six and eight hours after...