全身麻酔下口腔外科手術における術後痛抑制対策に関する研究

  • 阿部 幸作
    日本歯科大学新潟歯学部口腔外科学第1講座
  • 山口 晃
    日本歯科大学新潟歯学部口腔外科学第1講座
  • 土川 幸三
    日本歯科大学新潟歯学部口腔外科学第1講座

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  • Study of alleviation of pain after oral and maxillofacial surgery under general anesthesia.

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To find an effective way to control postoperative pain, we focused on pre-emptive analgesia and assessed postoperative pain in patients given analgesic agents with different mechanisms of action before operation. The subjects were 38 patients who underwent radical maxillary sinus surgery under general anesthesia. Lidocaine hydrochloride, ketamine hydrochloride, and flurbiprofen axetil were used. The patients were divided into four groups: a local anesthesia group (LA group), a ketamine hydrochloride group (KH group), a flurbiprofen axetil group (FA group), and a control group. Each drug was administered before surgery. Postoperative pain was assessed on the basis of pain scores on a visual analogue scale and postoperative analgesic requirement time.<BR>1. The pain scores 1 and 2 hours after returning to the room were significantly lower in the KH group and the FA group than in the control group. Postoperative pain was well controlled in both groups, and it was better controlled in the FA group than in the KH group.<BR>2. The interval until the first postoperative analgesic was significantly longer in the LA, KH, and FA groups than in the control group, and postoperative pain was better controlled in the treated groups. Significant differences were not seen among the three groups.<BR>3. Postoperative pain control continued longer than the duration of analgesic effectiveness in the LA, KH, and FA groups. This finding suggested the involvement of pre-emptive analgesia.

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