罗哌卡因胆囊三角区局部浸润对腹腔镜胆囊切除术后镇痛的效果研究

Research on the effect of ropivacaine local infiltration of Calot triangle for analgesia after laparoscopic cholecystectomy

目的:观察罗哌卡因胆囊三角区局部浸润用于腹腔镜胆囊切除术后镇痛的效果。方法:将择期行腹腔镜胆囊切除术患者120例随机平分为两组,对照组在胆囊分离前于胆囊三角区组织注射0.9%氯化钠注射液10 m L;试验组给予等容量0.75%盐酸罗哌卡因。记录术后2、4、6、12、24、48 h静态和动态的VAS评分;记录术后48 h内PCIA泵药物消耗量、总按压次数和有效按压次数、补救镇痛药的使用情况及不良反应的发生情况。结果:与对照组相比,试验组术后2、4、6、12、24 h静态和动态的VAS评分及48 h动态的VAS评分明显降低,PCIA总按压次数和有效按压次数、镇痛泵药物消耗量及补救镇痛药布托啡诺量均减少,镇痛不全发生率明显降低(P<0.05或0.01)。结论:罗哌卡因胆囊三角区浸润麻醉可安全有效地用于腹腔镜胆囊切除术,进一步减轻患者术后疼痛,减少术后补救镇痛药的用量。

Objective:To observe the effect of ropivacaine local infiltration of Calot triangle for analgesia after laparoscopic cholecystectomy.Methods:120 patients with the elective laparoscopic cholecystectomy were randomly divided into the two groups.Patients in the control group were injected with 0.9% saline 10 m L at the Calot triangle before the gallbladder was isolated.Patients in the experimental group were given equal volume of 0.75% ropivacaine.The static and dynamic VAS scores of 2,4,6,12,24,48 h were recorded.We record the drug consumption of PCIA pump within 48 h after operation,the total press times and effective press times,the use of the remedy for analgesics and the occurrence of adverse reactions.Results:The static and dynamic VAS scores of 2,4,6,12,24 h and the dynamic VAS score of 48 h of the control group were significantly decreased compared with the control group;the total press times and the number of effective press times of PCIA,drug consumption of analgesic pump and the amount of remedy analgesic butorphanol were all decreased;the incidence of analgesia was significantly lower(P<0.05 or0.01).Conclusion:Ropivacaine infiltration anesthesia of Calot triangle can be used safely and effectively in laparoscopic cholecystectomy.It can further reduce postoperative pain,and reduce the dosage of postoperative relief for analgesics.