高乌甲素用于腹腔镜胆囊切除术后镇痛的临床观察

Analgesic Effect of Lappaconitine After Laparoscopic Cholecystectomy

目的 观察高乌甲素在腹腔镜胆囊切除 (LC)术后 2 4h的镇痛效果。方法 择期LC手术患者 60例随机分为三组 ,Ⅰ组 (n =2 0 )高乌甲素 4mg肌注 ,Ⅱ组 (n =2 0 )高乌甲素 8mg肌注 ,Ⅲ (n =2 0 )对照组。Ⅰ ,Ⅱ组均于手术结束前 2 0min给药 ,Ⅲ组不做镇痛处理 ,采用视觉模拟评分 (VAS)法分别对三组术后 2 ,6,12 ,2 4h进行疼痛评分并记录下床活动时间 ,病人满意率及皮肤瘙痒、恶心呕吐等副反应。结果 术后2 4h内Ⅰ ,Ⅱ组VAS分较对照组有显著差异 (P <0 .0 5 ) ,且Ⅰ ,Ⅱ组比对照组下床活动早、满意率高也不增加瘙痒、恶心呕吐等副反应。结论 应用高乌甲素 4～ 8mg对LC术后镇痛有良好效果 ,不增加副作用。

Objective To study the analgesic effect of lappaconitine (LAP) in patients after laparoscopic cholecystectomy (LC). Methods Sixty patients aging 30～75 were at random divided into three groups (20 patients per group). Group Ⅰ received LAP 4mg and group Ⅱ 8mg 20 minutes earlier before the end of operation, while group Ⅲ (control group) did not receive any analgesic. Pain scaling were then performed using visual analogue scales. The patients' out-of-bed activity time, satisfaction rate, side effects including the degree of skin itch, nausea and vomiting were recorded in 2, 6,12, and 24 hours after operation.Results Compared with the control group (group Ⅲ), thepain scaling of patients who had received LAP (group Ⅰand group Ⅱ) were significantly lower (P<0.05), the time of the patients' out-of-bed activity were shorter and satisfaction rate were higher, but the side-effects such as itch of skin, nausea and vomiting did not.Conclusion Compared with the control group (group Ⅲ), the pain scalings of the patients who had received LAP (group Ⅰand group Ⅱ) were significantly decreased (P<0.05), and the patients' out-of-bed activity time was shorter and satisfaction rates were higher, but the side effects such as itch of skin, nausea and vomiting did not increased.