摘要
目的探讨与传统利多卡因局部麻醉相比利多卡因加用罗哌卡因在腹股沟无张力疝修补术中的优势。方法回顾性分析2012年1月至2013年12月收治的腹股沟疝患者172例,随机分为接受罗哌卡因联合利多卡因局部麻醉(试验组,88例)和利多卡因局部麻醉(对照组,84例),均行腹股沟疝无张力修补术(预成型网塞加补片修补腹股沟管后壁)。采用SPSS 17.0统计软件包进行分析,比较两组患者手术时间、术后止痛持续时间、离床活动时间、出院时间等采用t检验;术后应用止痛药物情况和患者对麻醉满意情况,采用χ2检验,P<0.05为差异有统计学意义。结果手术时间:试验组平均(41±8)min,对照组(43±7)min,两组比较差异无统计学意义。试验组术后止痛持续时间平均(7.4±1.6)h,对照组(4.8±1.8)h(t=10.023,P<0.001);术后24 h试验组18例患者使用止痛药物,对照组有31例因疼痛使用止痛药物镇痛(χ2=5.709,P=0.017);离床活动时间:试验组患者平均(4.6±0.8)h,对照组(6.7±1.4)h(t=12.147,P<0.001);平均出院时间试验组(2.7±0.4)d,对照组(3.6±0.5)d(t=13.065,P<0.001);对疼痛满意情况:试验组74例,对照组57例(χ2=6.238,P=0.013),以上两组患者比较差异均有统计学意义。结论加用罗哌卡因联合利多卡因局部麻醉行腹股沟疝无张力修补术较单纯利多卡因麻醉效果更佳,术后疼痛减轻,且恢复快,并发症少,费用低,患者满意度高,适合广泛应用。
Objective To investigate the advantages of combined application of lidocaine and ropivacaine in local anesthesia of tension-free inguinal hernia repair.Methods From January 2012 to December 2013, 172 patients with inguinal hernia were randomly divided into 2 groups：88 patients in lidocaine＋ropivacaine group （test group） and 84 patients in lidocaine group （control group） , all of whom received tension-free repair . Clinical data were analyzed retrospectively by using SPSS 17.0 software.The operation time, analgesic duration, time to ambulation, hospital stay were compared by using the t test , while postoperative use of analgesic and anesthesia satisfaction of patients were compared by using χ2 test.P 〈0.05 was considered statistically significant.Results Operation time of the test group was （41 ±8） minutes, which was not significantly shorter than that of the control group [（43 ±7） minutes （t=1.742, P=0.083）].The analgesic duration of the test group was （7.4 ±1.6） hours, which was longer than that of [（4.8 ±1.8） hours] the control group, （t=10.023, P〈0.001）.There were 18 patients using painkillers in the test group 24 hours after operation, significantly less than 31 patients in the control group （χ2 =5.709, P=0.017）.The mean time to ambulation of the test group was （4.6 ±0.8） hours, which was significantly shorter than that of the control group[（6.7 ±1.4） hours （t=12.147, P〈0.001）].The mean discharge time of the test group was （2.7 ±0.4） days, which was significantly shorter than that of the control group [（3.6 ±0.5） days （t=13.065, P〈0.001）].74 patients were satisfied with the aesthetic effect in the test group, in contrast to 57 patients in the control group of （χ2 =6.238, P=0.013）.＆amp;nbsp;Conclusion Local anesthesia of ropivacaine combined with lidocaine in tension-free inguinal hernia repair is an effective and safe method with simple operation and minimal invasion , by which patients could gain less pain, faster recov
出处
《中华普外科手术学杂志（电子版）》
2014年第3期24-26,共3页
Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)
基金
国家科技支撑计划基金项目(2008BAK47B08)
吴阶平基金会基金项目(320.6750.1282)
关键词
疝
腹股沟
麻醉
局部
利多卡因
罗哌卡因
Hernia,inguinal
Anesthesia,local
Lidocaine
Ropivacaine
