摘要
目的观察布比卡因切口阻滞应用于妇科腹腔镜手术的超前镇痛效果。方法40例择期行腹腔镜卵巢囊肿手术的患者,全身麻醉后单盲、随机分为两组:观察组在切皮前予0．25%布比卡因9～12mL(每个切口3mL)进行切口全层浸润;对照组不予局部麻醉处理。分别观察记录术后1、2、8、24、48h患者静息及运动状态下的疼痛视觉模拟(VAS)评分,并对比伤口愈合情况。结果术后1～24h,观察组静息及运动状态下的VAS评分均显著低于对照组(P值均＜0．01);术后48h,两组静息状态下VAS评分的差异无统计学意义(P＞0．05),而运动状态下观察组明显低于对照组(P＜0．05)。对照组术后24h内各时间点VAS评分＞3分的发生率为5%～45%,以术后2h的发生率最高,其中2例术后2h运动状态下的VAS评分达8分;而观察组各时间点的VAS评分＞3分的发生率均为0。两组伤口愈合质量的差异无统计学意义(P＞0．05)。结论预先以布比卡因行切口浸润应用于妇科腹腔镜手术的术后镇痛安全、有效。
Objective To investigate the preemptive analgesic effects of bupivacaine infiltration at incision in laparoscopic ovariectomy. Methods Forty patients due to receive laparoscopic ovariectomy under general anesthesia were randomly divided into two groups： patients in the experimental group received periportal infiltration with 0.25 % bupivacaine 9-12 mL before incision, and patients in the control group were given no local anesthetic. The pain scores at rest and during movement were assessed with VAS at 1, 2, 8, 24, 48 h postoperatively. Results The postoperative VAS values of incisional pain at rest were significantly lower in the experimental group than in the control group within 24 hours（0.1-0.6 vs 1.4-2.6, P 〈 0.01）. The pain was also less intense during movement of patient in the experimental group throughout the postoperative period. The average VAS scores during movement were 0.3-1.0 and 1.8-3.4 in the experimental and control group, respectively（P 〈 0.01 or P 〈 0.05）. The VAS〉3 occured in 5 %-45 % of the control patients within 24 hours, with the highest at 2 hours after operation; two patients suffered intense pain during movement （VAS〉 8）. No patient in the experimental group had VAS〉3 at any situation within 48 hours postoperatively. There was no difference in the quality of incision healing between the two groups. Conclusion Preoperative bupivacaine infiltration can significantly relieve the postoperative incisional pain in the patients receiving laparoscopic ovariectomy. （Shanghai Med J, 2007, 30 ： 41a-415）
出处
《上海医学》
CAS
CSCD
北大核心
2007年第6期413-415,共3页
Shanghai Medical Journal
