روش‌های دارویی و غیردارویی کنترل درد در زنان تحت عمل جراحی سزارین: یک مطالعه مروری نقلی

نوع مقاله : مروری

نویسندگان

1 استادیار گروه بیهوشی، مرکز تحقیقات بیهوشی، مراقبت ویژه و کنترل درد، دانشکده پزشکی، دانشگاه علوم پزشکی هرمزگان، بندرعباس، ایران.

2 مربی گروه بیهوشی، مرکز تحقیقات بیهوشی و کنترل درد، دانشکده پزشکی، دانشگاه علوم پزشکی جهرم، جهرم، ایران.

3 استادیار گروه بیهوشی، دانشکده پزشکی، دانشگاه علوم پزشکی قم، قم، ایران.

4 دانشیار گروه بیهوشی، مرکز تحقیقات بیهوشی، مراقبت ویژه و کنترل درد، دانشکده پزشکی، دانشگاه علوم پزشکی هرمزگان، بندرعباس، ایران.

چکیده

مقدمه: امروزه سزارین یکی از اعمال جراحی رایج مامایی و یکی از شایع‌ترین اعمال جراحی در زنان می‌باشد. روش‌های دارویی و غیر‌دارویی زیادی در عمل جراحی سزارین برای کنترل درد مورد استفاده قرار می‌گیرد. مطالعه مروری حاضر با هدف بررسی روش‌های دارویی و غیردارویی کنترل درد در زنان تحت عمل جراحی سزارین انجام شد.
روش‌کار: در این مطالعه مرور نقلی جهت یافتن مطالعات مرتبط، پایگاه‌های اطلاعاتی فارسی زبان SID، Magiran و Google Scholar با کلید واژگان فارسی: روش‌های دارویی، غیر‌دارویی، کنترل درد، درد و سزارین مورد جستجو قرار گرفتند. معیارهای ورود مقالات شامل: مقالات فارسی که فقط بر روی درد در زنان تحت عمل سزارین به دو روش بیهوشی عمومی و بی‌حسی اسپاینال پرداخته بودند و همچنین مقالات پژوهشی اصیل و از نوع کارآزمایی بالینی بود و مطالعاتی که در عنوان آنها درد در سزارین به‌کار رفته بود.
یافته­ ها: در این مطالعه 74 مقاله در دو دسته روش‌های دارویی و غیر‌دارویی مورد بررسی قرار گرفت. داروهای مورد بررسی در روش‌های دارویی شامل: مخدرها، ضدالتهاب‌های غیراستروئیدی، بی‌حس‌کننده‌های موضعی، تنظیم‌کننده سیکل‌های خواب و بیداری، هوشبرهای وریدی، بنزودیزپین‌ها، آنتی‌فیبرینولیتیک، آنتاگونیست NMDA و آنتی‌دوپامنیرژیک و روش‌های غیر‌دارویی شامل: رایحه درمانی، موسیقی‌درمانی، تمرین‌های ورزشی، رفلکسولوژی پا، اوریکلوتراپی، ماساژ، لمس‌درمانی، باز ماندن صفاق، تماس کانگرویی، آرام‌سازی بنسون و تحریک الکتریکی عصب از طریق پوست بود.
نتیجه­ گیری: مطالعه حاضر مروری کلی برای گردآوری تمام روش‌های دارویی و غیر‌دارویی کنترل درد بعد از سزارین بود که در غالب مطالعات بررسی شده، تأثیر‌گذاری به‌سزای این روش‌ها گزارش شده بود؛ با این‌حال تعیین خطرات احتمالی و یا رتبه‌بندی مداخلات ممکن نبوده و نیازمند مطالعات بیشتری است، اما پزشک معالج می‌تواند بر اساس شرایط بیمار از هر کدام از این روش‌ها استفاده کند.

کلیدواژه‌ها

عنوان مقاله [English]

Pharmacological and non-pharmacological methods of pain control in women undergoing caesarean section: a narrative review

نویسندگان [English]

  • Pourya Adibi 1
  • Navid Kalani 2
  • Bibi Mona Razavi 1
  • Somayeh Mehrpour 3
  • Tayyebeh Zarei 1
  • Mehrdad Malekshoar 1
  • Samira Zanbagh 1
  • Majid Vatankhah 4
1 Assistant Professor, Department of Anesthesiology, Anesthesiology & Critical Care and Pain Management Research Center, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
2 Instructor, Department of Anesthesiology, Anesthesia and Pain Control Research Center, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.
3 Assistant Professor, Department of Anesthesiology, Faculty of Medicine, Qom University of Medical Sciences, Qom, Iran.
4 Associated Professor, Department of Anesthesiology, Anesthesiology & Critical Care and Pain Management Research Center, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
چکیده [English]

Introduction: Nowadays, cesarean section is one of the common obstetric surgeries and one of the most common surgeries in women. Many pharmacological and non-pharmacological methods are used in cesarean surgery to control pain. This review study was performed aimed to review the pharmacological and non-pharmacological methods of pain control in women undergoing cesarean surgery.
Methods: In this narrative review study, to find the relevant studies, Persian language databases of "SID, Magiran" and "Google Scholar" was searched with the Persian key words of pharmaceutical, non-pharmacological methods, pain control, pain and cesarean section.
Results: In this study, 74 articles in two categories of pharmacological and non-pharmacological methods were examined. Drugs which were studied in pharmaceutical methods include: opiates, non-steroidal anti-inflammatories, local anesthetics, regulators of sleep and wake cycles, intravenous sedatives, benzodiazepines, antifibrinolytics, NMDA antagonists and antidopaminergic. Non-pharmacological methods include: aromatherapy, music therapy, sports exercises, foot reflexology, auriculotherapy, massage, touch therapy, keeping the peritoneum open, kangaroo contact, Benson relaxation and electrical stimulation of the nerve through the skin (TENS).
Conclusion: The present study conducted a general review to collect all the pharmacological and non-pharmacological methods of controlling pain after cesarean section which has been reported in most of the reviewed studies to be effective for pain control; however, it is not possible to determine possible risks or to rank the interventions, and more studies are needed. But the attending physician can choose among the methods based on the condition of patient.

کلیدواژه‌ها [English]

  • Caesarean section
  • Non-pharmacological methods
  • Pharmacological methods
  • Postoperative pain

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مجله زنان، مامایی و نازایی ایران
دوره 25، شماره 7
مهر 1401
صفحه 91-112

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