腹腔镜结直肠癌手术后早期筋膜下注射罗哌卡因在术后镇痛中的应用研究

Application research of subfascial infusion of ropivacaine in early recovery stage of laparoscopic colorectal cancer surgery

目的:比较腹腔镜结直肠癌术后早期筋膜下连续注射罗哌卡因及术后芬太尼自控镇痛静脉泵的镇痛效果,评价其不良反应与安全性。方法:选择2013年1月至2016年12月收治的84例腹腔镜结直肠癌手术患者,将患者随机分为筋膜下罗哌卡因注射组(研究组)与静脉芬太尼泵组(对照组),每组42例。记录两组患者静息、咳嗽时疼痛评分、术后恢复情况、患者对术后镇痛效果满意度及不良反应。结果:两组患者一般情况差异无统计学意义(P>0.05),研究组患者在静息、咳嗽时,术后1 h、6 h的疼痛评分均低于对照组(P<0.05)。两组术后不良反应发生率、术后早期恢复指标差异无统计学意义(P>0.05),研究组患者术后0~24 h的镇痛满意度高于对照组(P<0.05)。结论:腹腔镜结直肠癌手术早期筋膜下注射罗哌卡因镇痛效果满意,可满足术后镇痛的需求,安全、可行。

Objective：To compare the analgesic efficacy of subfascial infusion of ropivacaine with patient-controlled analgesia fentanyl intravenous pump in early recovery stage of laparoscopic colorectal cancer surgery and to evaluate the side effects and safety . Methods：Eighty-four patients who underwent laparoscopic colorectal cancer surgeries from Jan .2013 to Dec.2016 were selected.Pa-tients were randomly divided into study group （ subfascial infusion of ropivacaine ） and control group （ fentanyl intravenous pump ） .Each group contained 42 patients .The pain scores at rest and coughing ,postoperative recovery ,postoperative satisfaction and adverse reactions were recorded.Results：There was no significant difference between the two groups in basic characteristics （P〉0.05）.The pain scores at rest or coughing of postoperative 1 h and 6 h in the study group were significantly lower than those in the control group （P〈0.05）. There was no significant difference in the incidence of adverse reactions and the early postoperative recovery indicators between the two groups （P〉0.05）.The satisfaction degree of postoperative analgesia within 0-24 h in the study group was significantly higher than that in the control group （P〈0.05）.Conclusions：Subfascial infusion of ropivacaine is safe and feasible ,can basically meet the needs of postoperative analgesia in early recovery stage of laparoscopic colorectal cancer surgery ,and analgesic effect is satisfactory .