多模式超前镇痛对卵巢囊肿腹腔镜术后疼痛及IL-6的影响

Multimodal Preemptive Analgesia on Pain after Laparoscopic Surgery of Ovarian Cysts and Stress Reaction

目的探讨多模式超前镇痛对卵巢囊肿腹腔镜术后疼痛及IL-6的影响。方法择期行卵巢囊肿腹腔镜手术的患者100例,随机分为2组(n=50),A组术前30min缓慢静注氯诺昔康8mg,手术开始前以0.238%甲磺酸罗哌卡因15mL+氯诺昔康8mg切口浸润及0.238%罗哌卡因行50mL行手术部位浸润和腹腔喷洒,B组同等容量和浓度甲磺酸罗哌卡因、氯诺昔康在病灶切除后行切口和手术部位浸润及腹腔喷洒,手术结束时静注鲁诺昔康8mg。分别于术前30min、术毕即刻(均未给氯诺昔康时)、术后3、12、24h抽取外周静脉血测白介素-6(IL-6),并于术后不同时点观察疼痛视觉模拟评分(VAS)。结果术后2组间VAS评分有显著差异(P<0.05),A组术后能有效抑制应激反应。结论多模式超前镇痛用于妇科腹腔镜手术,可减轻术后疼痛,减少镇痛药用量,有效抑制术后机体应激反应。

Objective To investigate the multi--modal analgesia after laparoscopic surgery for ovarian cysts and the stress response to pain.Methods Elective laparoscopic ovarian cyst surgery 100 patients were randomly divided into two groups （n=50）,groupA preoperative 30min slow intravenous lornoxicam 8mg,0.238% before surgery to a ropivacaine 15mL＋ lornoxicam 8rag incision infiltration and 0.238% ropivacaine 50ml site infiltration and abdominal surgery Spray,group B the same volume and concentration of ropivacaine mesylate,lornoxicam underwent resection of the lesion and the surgical site wound infiltration and peritoneal spraying the end of surgery 8rag intravenous Bruno Kang Xi.Before surgery were 30rain,of surgery immediately （no time to lornoxicam）,after 3h,12h,24h measured in peripheral blood collected interleukin -6 （IL-6）,cortisol and blood glucose.Observed at different time points after the pain visual analogue scale （VAS）.Results VAS scores between 2 groups were significantly different （P〈0.05）,A group can effectively inhibit the stress response. Conclusion Mnltimodal analgesia for laparescopic surgery,reduce postoperative pain,reduce consumption of analgesics, effectively inhibit the stress response after surgery.