Local anesthesia with ropivacaine for patients undergoing laparoscopic cholecystectomy

AIM:To investigate the effect of pain relief after infu-sion of ropivacaine at port sites at the end of surgery.METHODS:From October 2006 to September 2007,72 patients undergoing laparoscopic cholecystectomy(LC) were randomized into two groups of 36 patients.One group received ropivacaine infusion at the port sites at the end of LC and the other received normal saline.A visual analog scale was used to assess postoperative pain when the patient awakened in the operating room,6 and 24 h after surgery,and before discharge.The amount of analgesics use was also recorded.The demographics,laboratory data,hospital stay,and perioperative complications were compared between the two groups.RESULTS:There was no difference between the two groups preoperatively in terms of demographic and lab-oratory data.After surgery,similar operation time,blood loss,and no postoperative morbidity and mortality were observed in the two groups.However,a significantly lower pain score was observed in the patients undergo-ing LC with local anesthesia infusion at 1 h after LC and at discharge.Regarding analgesic use,the amount of meperidine used 1 h after LC and the total used during admission were lower in patients undergoing LC with local anesthesia infusion.This group also had a shorter hospital stay.CONCLUSION:Local anesthesia with ropivacaine at the port site in LC patients signif icantly decreased post-operative pain immediately.This explains the lower meperidine use and earlier discharge for these patients.

腹股沟疝无张力修补术86例

目的分析研究腹股沟疝充填式无张力修补术的临床应用价值、应用前景及术后并发症。方法对86例腹股沟疝患者采用美国Bard公司专利定型产品Marlex Mesh Perfix Plug行疝环充填式无张力疝修补术。结果手术平均历时35～40 min,平均住院5 d,术后4～10 h均能下床活动。出现切口疼痛12例,其中2例有疼痛感2周,能耐受,未用止痛药自行缓解,1例有异物感长达2个月。结论腹股沟疝充填式无张力修补术对腹股沟疝的解剖缺陷有针对性,符合生理,创伤小,修补快,并发症少,恢复快,复发率低,手术适应证宽,具有良好的临床应用价值和广泛的应用前景。

Effect of electroacupuncture at different time points on the recovery of gastrointestinal function after surgery for gastrointestinal malignant neoplasms

Objective To observe the effect of electroacupuncture(EA)at different time points during the perioperative period on the recovery of gastrointestinal function after gastrointestinal malignant neoplasms surgery.Methods Sixty-three patients who needed radical surgery for gastrointestinal tumors were randomized into a control group,treatment group 1(postoperative EA group),and treatment group 2(intraoperative and postoperative EA group).The control group received surgery and conventional Western medicine treatment,and treatment groups 1 and 2 received additional EA treatment at different time points.The initial flatus time after the surgery,visual analog scale(VAS)score at different time points after the surgery,the proportion of using patient-controlled analgesia(PCA)after the surgery,and the times of adding analgesics were observed in the three groups.Results The initial flatus time after the surgery was earlier in treatment groups 1 and 2 than in the control group(P<0.05);the difference between treatment groups 1 and 2 was statistically insignificant(P>0.05).The VAS score was lower in treatment group 2 than in the control group at 6,12,24,and 72 h after the surgery(P<0.05);the VAS score was lower in treatment group 1 than in the control group only at 72 h after the surgery(P<0.05).There were no significant differences in the rate of using PCA among the three groups(P>0.05).Regarding the times of adding analgesics,it was less in treatment group 2 than in the control group at 12 h after the surgery(P<0.05).Conclusion Either EA during and after the surgery or only after the surgery can hasten the initial flatus and boost the recovery of gastrointestinal function in patients after radical resection of gastrointestinal neoplasms.Successive EA during and after the surgery should be superior to postoperative EA regarding the analgesic effect after the surgery.