利多卡因静脉输注在腹腔镜胆囊切除术后疼痛及应激、炎性反应的影响

Effect of lidocaine intravenous infusion on pain, stressand inflammatory response after laparoscopic cholecystectomy

目的:探析腹腔镜胆囊切除术患者采用利多卡因静脉输注对术后恢复的影响。方法:78例腹腔镜胆囊切除术患者均取自2022年7月至2023年7月天水市第一人民医院收治的患者中,将其随机均分为两组,各39例。对照组予以全麻,观察组加利多卡因静脉输注。对两组应激指标、炎性反应、疼痛评分及并发症发生率。结果:两组治疗前应激反应指标水平比较无差异(P>0.05),观察组治疗后应激反应指标包括ACTH(116.35±8.12)pg/mL、皮质醇(146.65±5.15)pg/mL水平较对照组低,组间差异显著(P<0.05),两组治疗前炎性反应水平比较无差异(P>0.05),观察组治疗后炎性反应水平包括C反应蛋白(18.65±5.32)ng/L、肿瘤坏死因子-α(25.35±3.45)μg/L、白细胞介素-6(84.32±5.32)ng/L较对照组低(P<0.05),观察组治疗后VAS较对照组低(P<0.05),观察组并发症发生率较对照组低(P<0.05)。结论:利多卡因静脉输注在腹腔镜胆囊切除术治疗中效果明显,患者机体应激反应和炎性水平明显下降,其疼痛感减轻,有效降低并发症。

Objective:Exploring the effect of intravenous infusion of lidocaine on postoperative recovery in patients undergoing laparoscopic cholecystectomy.Methods:78 patients with laparoscopic cholecystectomy were selected from the patients admitted to Tianshui First People's Hospital from July 2022 to July 2023,and were randomly divided into 2 groups with 39 cases in each group.The control group was given general anesthesia,and the observation group was given lidocaine intravenous infusion.Stress index,inflammatory response,pain score and complication rate were studied in both groups.Results:There was no difference in the level of stress response indexes between the two groups before treatment(P>0.05).The level of ACTH(116.35±8.12)pg/mL and cortisol(146.65±5.15)pg/mL in the observation group after treatment was lower than another group(P<0.05).The inflammatory response levels of the observation group,including C-reactive protein(18.65±5.32)ng/L,tumor necrosis factor-α(25.35±3.45)μg/L and interleukin-6(84.32±5.32)ng/L after treatment were lower than those of the control group(P<0.05).There was no difference in VAS score between the two groups before treatment(P>0.05),VAS in the observation group was lower than another group(P<0.05),and the complication rate in the observation group was lower than another group(P<0.05).Conclusion:Lidocaine intravenous infusion has obvious effect in the treatment of laparoscopic cholecystectomy,the stress response and inflammatory level of the patients are significantly decreased,the pain is alleviated,and the complications are effectively reduced,which can be used for reference and promotion in clinical practice.