右美托咪定对腹腔镜胆囊切除术罗哌卡因镇痛效果的影响

Application of FTS in postoperative analgesia after laparoscopic cholecystectomy

目的右美托咪定对腹腔镜胆囊切除术罗哌卡因镇痛效果的影响。方法选择80例择期行腹腔镜胆囊切除术(LC)的患者,随机分为FTS组(n=40)与对照组(n=40)。对照组在FTS理论指导下行LC,术后缝合戳口时给予0.50%罗哌卡因切口注射处理;FTS组在FTS理论指导下行LC术[1],且在术后缝合戳口时,使用0.50%罗哌卡因+0.50μg/kg右美托咪定行切口注射。记录两组患者术后2、4、6、8、12、24 h的视觉模拟评分(VAS评分)。AS评分、住院时间、住院总费用、睡中痛醒人数,并记录术后并发症发生情况。结果 FTS组术后6、8、12 h的VAS显著低于对照组(P<0.05),但术后2、4、24 h的VAS与对照组比较,差异无统计学意义(P>0.05)。两组的住院总费用比较差异无统计学意义。但两组的术后住院时间的比较,差异有统计学意义(P<0.01)。术后FTS组睡中痛醒2例,对照组睡中痛醒7例,无法睡眠2例,两组数据差距有统计学意义;对照组与FTS组均未出现腹腔感染、切口感染等并发症。结论在快速康复外科理念指导下,罗哌卡因复合右美托咪定在腹腔镜胆囊切除术术后镇痛以及加快患者术后康复中具有临床意义。

Objective To observe the clinical application of ropivacaine combined with dexmedetomidine in the postoperative analgesia of laparoscopic cholecystectomy under the guidance of Fast track surgery（ FTS） theory. Methods 80 patients undergoing selective laparoscopic cholecystectomy（ LC） were randomly divided into FTS group（ n = 40） and control group（ n = 40）. Injection of0. 50% ropivacaine in the control group when suturing the incision after operation. In group FTS,LC was performed under the guidance of FTS theory,and 0. 50% ropivacaine ＋ 0. 50 g/kg right metodetonidine was injected into the incision after the operation. The visual analogue score（ VAS score） of 2,4,6,8,12,24 h after operation was recorded in two groups of patients. Results Under the guidance of fast track surgery,ropivacaine combined with dexmedetomidine has clinical significance in postoperative analgesia after laparoscopic cholecystectomy and accelerating postoperative rehabilitation. Conclusions The time of hospitalization,the total cost of hospitalization,the number of sleeping sore wakes,and the incidence of postoperative complications were recorded in the two groups.