Source: Eur J Gastroenterol Hepatol | Posted 6 days ago
经皮肝穿刺活检前的预防性镇痛的临床比比较研究
Prophylactic analgesia before percutaneous liver biopsy: a clinical
comparative study
Kramskay R, Tansky A, Eisenberg E, Veitsman E, Baruch Y
European Journal of Gastroenterology and Hepatology (Jun 2011)
INTRODUCTION: Liver biopsy remains the gold standard for the diagnosis and
staging of liver diseases. Despite being painful, analgesia before liver
biopsy is usually avoided due to the notion that pain is minor and due to
the concern of masking possible abdominal symptoms. Postbiopsy pain levels
were previously mapped for the purpose of analgesia planning. AIM: To
compare pain and anxiety levels between two prophylactic treatment
regimens, a combination of sublingual tramadol Hcl with oral lorazepam and
oral diazepam only. PATIENTS AND METHODS: One hundred and thirteen
consecutive patients were selected to receive either prophylactic analgesia
with sublingual tramadol Hcl (50 mg) flashtabs and oral lorazepam [(1 mg)
analgesia group (AG), n=56] or oral diazepam (5 mg) alone [nonAG (NAG),
n=57]. Pain and anxiety levels were assessed using Visual Analogue Scale
(1-10) and State Anxiety Inventory, respectively, 30 min before, and 30 min
and 6 h after the biopsy. RESULTS: The groups were comparable with respect
to baseline characteristics. Thirty minutes after the procedure, pain
levels were significantly lower in the AG (mean Visual Analogue
Scale±standard error of the mean, 1.8±0. 3; median=1) compared with the
NAG (3.1±0.3, median=3; P<0.005). Patients in the NAG (13.8%), reported
high pain intensities (>7) compared with the patients in the AG (3.6%;
P=0.09). Six hours after the procedure, pain intensity remained
significantly lower in the AG compared with the NAG (0.8±0.1 vs. 1.5±0.2;
P<0.005). Anxiety levels were comparable. CONCLUSION: Prophylactic
combination of short-acting tramadol and lorazepam is effective, safe, and
can be used routinely before liver biopsy. 作者: StephenW 时间: 2011-7-19 15:30