Patient-controlled Analgesia
Conditions
Keywords
dezocine, sufentanil, laryngectomy, patient-controlled analgesia
Brief summary
Laryngeal cancer is one of the most common tumors in otolaryngology. In China, it accounts for 1-5% of all malignancies and has an incidence of 1.13 per 100,000. Surgical resection is the most important treatment for patients who are not candidates for chemoradiotherapy or refuse chemoradiotherapy. The types of surgery include total and partial laryngectomy. Patients with laryngeal cancer often face multiple physical and psychiatric changes after surgery, such as daily large sputum production accompanied by cough, cleaning care of the air incision, fatigue, and sleep disturbances. Some patients do not actively exclude secretions due to pain, and the formation of sputum plugs causes lung inflammation, which is not conducive to postoperative recovery. Good postoperative pain management is beneficial to shorten the length of hospital stay and reduce mortality. Sufentanil is most commonly used for postoperative analgesia and has good analgesic effect, but there are some adverse effects, such as dizziness, nausea and vomiting, urinary retention, skin itching, respiratory depression, etc. As a new type of analgesic, dezocine has been widely used in clinical practice with few adverse reactions to the respiratory and circulatory system, and its application to postoperative analgesia can significantly improve the immune activity. At present, there are not many studies on continuous analgesia of dezocine, mostly single-dose analgesia studies, this study for different doses of dezocine for the postoperative analgesic effect of laryngeal cancer patients, compared with the current classic opioid analgesics, to provide a new scheme for clinical medication.
Detailed description
Laryngeal cancer is one of the most common tumors in otolaryngology. In China, it accounts for 1-5% of all malignancies and has an incidence of 1.13 per 100,000. Surgical resection is the most important treatment for patients who are not candidates for chemoradiotherapy or refuse chemoradiotherapy. The types of surgery include total and partial laryngectomy. Patients with laryngeal cancer often face multiple physical and psychiatric changes after surgery, such as daily large sputum production accompanied by cough, cleaning care of the air incision, fatigue, and sleep disturbances. In patients with laryngeal cancer, large amounts of secretions can cause frequent coughing, even wheezing, and coughing can exacerbate the degree of postoperative pain. Some patients do not actively exclude secretions due to pain, and the formation of sputum plugs causes lung inflammation, which is not conducive to postoperative recovery. In addition, the inability to verbalize after laryngeal cancer surgery puts patients in a state of anxiety, which increases the degree of postoperative pain. Good postoperative pain management is beneficial to shorten the length of hospital stay and reduce mortality. Sufentanil is most commonly used for postoperative analgesia and has good analgesic effect, but there are some adverse effects, such as dizziness, nausea and vomiting, urinary retention, skin itching, respiratory depression, etc. As a new type of analgesic, dezocine has been widely used in clinical practice with few adverse reactions to the respiratory and circulatory system, and its application to postoperative analgesia can significantly improve the immune activity. At present, there are not many studies on continuous analgesia of dezocine, mostly single-dose analgesia studies, this study for different doses of dezocine for the postoperative analgesic effect of laryngeal cancer patients, compared with the current classic opioid analgesics, to provide a new scheme for clinical medication.
Interventions
DRUGDezocine
dezocine for patient-controlled analgesia
sufentanil for patient-controlled analgesia
DRUGFlurbiprofen
Flurbiprofen for patient-controlled analgesia
granisetron has antiemetic function.
Sponsors
Eye & ENT Hospital of Fudan University
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
FEMALE
Healthy volunteers
No
Inclusion criteria
* Patients who underwent elective partial laryngectomy * American society of Anesthesiologists (ASA) physical status classification :Ⅰ\ Ⅱ
Exclusion criteria
* chronic pain * long-term use of analgesics * allergy to perioperative medications * previous postoperative nausea and vomiting
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| total | from the end of the surgery to 48 hours after surgery | no pain =0, mild pain =1-3, moderate pain =4-6, and severe pain =7-10 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| 48 hours pressing times of Patient-controlled Analgesia | From the time of use postoperative analgesic to the time of 48 hours after the surgery | the times of press analgesia pump in 24 hours after the surgery |
| Visual Analogue Scale | at the time of 6 hours after the surgery | no pain =0, mild pain =1-3, moderate pain =4-6, and severe pain =7-10 |
| the incidence of nausea | from the time when patients use postoperative analgesic to the time when patients stop to use postoperative analgesic, assessed up to 48 hours | the incidence of nausea |
| 24 hours amount of drug | From the time of use postoperative analgesic to the time of 24 hours after the surgery | the volume of postoperative analgesic in 24 hours after the surgery |
| the incidence of dizziness | from the time when patients use postoperative analgesic to the time when patients stop to use postoperative analgesic, assessed up to 48 hours | the incidence of dizziness |
| the incidence of urinary | from the time when patients use postoperative analgesic to the time when patients stop to use postoperative analgesic, assessed up to 48 hours | the incidence of urinary |
| the incidence of respiratory depression | from the time when patients use postoperative analgesic to the time when patients stop to use postoperative analgesic, assessed up to 48 hours | the incidence of respiratory depression |
| the incidence of vomiting | from the time when patients use postoperative analgesic to the time when patients stop to use postoperative analgesic, assessed up to 48 hours | the incidence of vomiting |
Countries
China
Outcome results
None listed