罗哌卡因浸润用于腹腔镜胆囊切除术后镇痛的临床观察

Ropivacaine Infiltration Analgesia in Patients Post Laparoscopic Cholecystectomy

目的:观察腹腔镜胆囊切除术(LC)后腹腔内应用罗哌卡因浸润麻醉对患者术后疼痛的缓解作用。方法:安慰剂对照和双盲的研究方法,将60名择期行LC的病人随机分为3组,A组术前以0.5%罗哌卡因逐层没润各切口并喷洒腹腔。B组方法同A组,时间为手术结束时。对照组使用生理盐水。记录术后1、3、6、24hVAS评分。3、6、24h腹腔内和切口疼痛VKS评分。结果:A、B组术后6b内VAS低于对照组,A、B组间无显著差异。术后3h切口和腹腔疼痛VRS评分A、B组低于对照组,A、B组间无差异,术后6hA组腹腔内疼痛VRS评分显著低于B组及对照组。结论:罗哌卡因切口浸润结合腹腔内喷洒可明显降低腹腔镜手术后早期VAS评分,具有良好的镇痛效果。术前与术后给药对镇痛效果无明显影响,但术前腹腔内浸润在减轻腹腔内疼痛方面可能优于术后给药。

Objective： To evaluate ropivacaine infiltration analgesia in patients receiced laparoscopic cholecystectomy （LC）. Method： 60 patients receiced selection LC were randomly divided into three groups： group A （n=20） infiltrate 0.5% ropivacaine 20 ml before LC; group B （n=20） infiltrate 0.5% ropivacaine 20 mL after LC, group C（ n=20） infiltrate saline 20 ml as control. Pain score were assessed after surgery 1,3,6,24 hours by visual analog scale （VAS）. The abdominal cavity and incisal opening pain were assessed after surgery 3,6,24 hours by VRS. Results： Compare with control group, the scores of VAS in group A and B decreased in 6hr postoperative but there were no different in group A and B. The scores of VRS in group A and B were lower than control group after 3hr surgery and no different in group A and B. Compare with control grou and group B, the scores of VRS in group A still decreased after 6 hr surgery. Conclusions： ropivacaine infiltrative anesthesia after LC can effectively reduce pain and is safe. Administration ropivacaine preoperative and after surgery were not obviously differed in analgesia effect but preoperative administration reduce pain of abdomina cavity compare with administration after surgery.