|
對住院病患手術後疼痛以電針刺激之「前瞻性止痛」治療的療效評估 孫維仁國立台灣大 |
|
| 我們先前的研究已經證實電針刺激可以減少手術後morphine的用量，為了深入研究「前瞻性止痛」的理論，是否參與在電針止痛的療效上，我們將進行一隨機及雙盲的臨床電針止痛實驗，來探討施行電針刺激的時間：分別是手術前、或手術後，給予電針刺激，對婦科接受子宮切除術的病患，在術後疼痛、病患自控式止痛(Patient-controlled analgesia, PCA) 的嗎啡累計用量及手術傷口疼痛過敏 (nociceptive hyperalgesia) 是否有明顯差異。住院病患分成兩組，在不同時間接受電針刺激：術前組在全身麻醉前刺激15分鐘、及手術後15分鐘接受第二次電針15分鐘，共30分鐘；而術後組只在手術開始後15分鐘，接受電針刺激30分鐘。在手術後 1 小時、4 小時、12 小時、24小時、及1個月，比較四組術後的視覺類比疼痛分數(Visual analogue scale, VAS)、嗎啡的用量、及傷口疼痛過敏現象。此外，相關的副作用如：噁心、嘔吐、口渴、及昏睡狀態。希望藉由對急性疼痛的人體模式，研究「前瞻性止痛」理論在電針止痛對手術後疼痛的重要性，作為臨床應用時的參考，同時藉此深入探討中醫傳統針灸技術在人體的鎮痛機轉。 | |
| 關鍵字：針灸、術後疼痛、前瞻性止痛、病患自控式止痛 |
|
The preemptive analgesic effect of electroacupuncture on postoperative pain in lower abdominal surgery Wei-Zen SunNational Taiwan university hospital |
|
| Our previous study demonstrated that electroacupuncture (EA) reduced the postoperative morphine comsumption. In order to further investigate the “preemptive analgesic effect” of electroacupuncture on the postoperative pain, we will conduct a randomized, double-blind clinical study to examine the timing of EA related to its analgesic efficacy. Obstetric patients who are subjected hysterectomy are randomly allocated into two groups: pre-incision group who receive 15-min EA pre-surgical incision, another the same duration of EA 15-min after surgical incisionand, and post-incision group who receive 30-min EA 15 min after surgical incision. We will compare differences of the postoperative pain by visual analogue scale, of morphine comsuption delivered from patient-controlled analgesia, and of the short term and long term pain threshold and nociceptive hyperalgesia of incision wound between two groups. Besides, we also compare the difference of side effects like nausea, vomtting, itching, | |
| 關鍵字：acupuncture, postoperative analgesia, preemptive analgesia, patient-controlled analgesia |
