Postoperative pain service following vaginal total hysterectomy

概要

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The postoperative pain of vaginal total hysterectomy (VTH) is thought to be comparatively less because the transvaginal approach does not involve abdominal skin wound. However, we often find it difficult to control postoperative pain following VTH. We conducted a case-control study to elucidate the efficacy and safety of continuous epidural analgesia after VTH. A total of 128 patients who underwent VTH at two institutions between January 2002 and August 2004 were recruited. Patients were classified into the two groups: one that had received combined continuous epidural analgesia and spinal analgesia (E group) and one that received spinal analgesia only (S group). We compared the numbers of analgesic agent given, the time until the first time administration of analgesic agent, visual analogue scale (VAS), Prince Henry pain scale (PHPS), the region of the pain and side effects in these two groups. The E group required a significantly lower amount of analgesic agents compared to that of the S group (1.8 vs. 3.7, p<0.05). The postoperative continuous epidural analgesia is significantly advantageous with regard to other factors such as VAS and PHPS. The postoperative pain of VTH can be unexpectedly serious, therefore the postoperative continuous epidural analgesia is useful to provide stable postoperative analgesic effects.
一般社団法人日本ペインクリニック学会の論文