摘要
目的评价腹腔镜腹壁切口疝修补术(LVHR)中在补片和腹膜之间注射长效局麻药布比卡因对术后早期疼痛与镇痛药使用剂量的影响。方法选取2015年8月至2016年8月在惠州市第三人民医院接受LVHR术的患者80例,随机分为布比卡因组与对照组,布比卡因组患者在LVHR术中于补片和腹膜间注射0.5%盐酸布比卡因注射液1 ml/cm2,对照组患者在术中注射相同剂量的氯化钠溶液。观察并比较患者在麻醉恢复室与返回病房后的疼痛程度、静脉及口服镇痛药物使用剂量和术后至正常进食及行走的时间。结果布比卡因组患者麻醉恢复室内的平均疼痛评分显著低于对照组(P=0.015),返回病房后第一个2 h内布比卡因组患者的疼痛评分显著低于对照组(P=0.003);2组患者在返回病房第一个2 h后各时间段内疼痛评分差异无统计学意义(P>0.05);2组患者术后至正常饮食及行走时间差异无统计学意义(P>0.05);布比卡因组患者术后4 h内及总静脉麻醉药物用量显著低于对照组(P=0.000),2组患者术后总口服止痛药量差异无统计学意义(P=0.885)。结论 LVHR术中在补片与腹膜之间注射长效局麻药布比卡因可以显著减轻术后早期疼痛程度和减少静脉镇痛药物用量。
Objective To evaluate whether injection of long-acting local anesthetic bupivacaine can reduce pain and narcotic requirements post operation. Methods We enrolled 80 patients who received LVHR procedure during August 2015 to August 2016,and divided them randomly into bupivacaine group and control group： patients in bupivacaine received injection of 0. 5% bupivacaine hydrochloride（ 1ml per square centimeter of the mesh） between the mesh and the peritoneum during the procedure,while patients in control group received injection of normal saline at the same dosage as bupivacaine group. Evaluated and compared patients’ pain intensity during in post anesthesia care unit and after return to the ward,narcotic medication required and time to regular diet intake and to ambulation after surgery. Results The VAS scores in bupivacaine group during the period in post anesthesia care unit and at the first 2 hours after returned to the ward were significantly lower than those in control group（ P = 0. 015,P = 0. 003）. The VAS scores in the two groups after the first 2 hours after returned to the ward were not significantly different（ P 〉 0. 05）. The times to regular diet intake and to ambulation after surgery of the two groups were also not significantly different（ P 〉 0. 05）. Intravenous anesthesia medication required by bupivacaine group within 4 hours after surgery and the total intravenous anesthesia medication dosage required were both significantly lower than those in control group（ P = 0. 000）,and the total oral anesthesia medication required by the two groups was not significantly different（ P 〉 0. 05）. Conclusion Administration of bupivacaine hydrochloride between the mesh and the peritoneum significantly reduces postoperative pain and venous narcotic medication required after LVHR.
出处
《中华疝和腹壁外科杂志（电子版）》
2017年第2期125-128,共4页
Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition)
关键词
布比卡因
腹膜
疝修补术
腹腔镜
疼痛
Bupivacaine
Peritoneum
Herniorrhaphy
Laparoscopes
Pain
