摘要
目的观察在腹腔镜胆囊切除术中于腹腔内局部喷洒罗哌卡因对术后疼痛的影响。方法选取80例择期行腹腔镜胆囊切除术患者，将其随机分为四组。实验I组：0．5％罗哌卡因20ml胆囊床喷洒浸润；实验Ⅱ组：0．5％罗哌卡因10ml胆囊床喷洒浸润及10m1膈下喷洒；对照I组：生理盐水20ml胆囊床注射；对照Ⅱ组：生理盐水10ml胆囊床注射及10ml膈下喷洒。采用疼痛视觉模拟评分法（VAS）评价术后1、4、8、24、48h各时间点静息时腹内疼痛、肩部放射痛、切口疼痛以及咳嗽时上述部位的疼痛情况。结果实验I、Ⅱ组术后1、4、8h腹腔内疼痛、切口疼痛及咳嗽时疼痛VAS评分与对照I、Ⅱ组相比差异有统计学意义（P〈0．05）；实验Ⅱ组1、4、8、24、48h肩部疼痛VAS评分与对照Ⅱ组较相比差异有统计学意义（P〈0．05），实验I组1、4、8、24、48h肩部疼痛VAS评分与实验Ⅱ组较明显高，差异有统计学意义（P〈0．05）。结论腹腔镜胆囊切除术腹腔内操作结束前0．5％罗哌卡因20ml胆囊床注射及膈下喷洒可有效减轻早期切口疼痛、咳嗽疼痛、肩部疼痛及内脏疼痛，且对晚期肩部疼痛也有较好作用。
Objective To observe the effect of intra-abdominal local spraying of ropivacaine on postoperative pain of laparoscopie cholecysteetomy（ LC）. Methods Eighty patients underwent e- lective laparoseopic choleeysteetomy were randomly divided into four groups： experimental group I ： 0.5% ropivacaine 20 ml gallbladder bed injection after LC; experimental group Ⅱ ：0.5% ropiva- caine 10 ml gallbladder bed injection and 10 ml diaphragm spray; control group I ： normal saline 20 ml gallbladder bed injection; control group 11 ： normal saline 10 ml gallbladder bed injection and 10 ml diaphragm spray. The abdominal pain at rest, shoulder pain, incision pain and pain when coughing were assessed by visual analog scale （VAS） at 1 , 4, 8, 24, 48 hours after surgery in each group. Results The abdominal pain, incision pain and coughing pain scores of experimental group I , II were significantly less than the control group I , Ⅱ at 1,4,8 hours after surgery （ P 〈 0.05 ） ; the shoulder pain score of experimental group Ⅱ was significantly less than the control group Ⅱ at each time after surgery （ P 〈 0.05） ; the shoulder pain score of experimental group I was significantly higher than the experimental group 11 at each time after surgery （ P 〈 0.05）. Conclu- sions Gallbladder bed injection and diaphragm spray of 0.5% ropivaeaine 20 ml after laparoscopic cholecysteetomy could relieve early abdominal pain, incision pain, shoulder pain, coughing pain and advanced shoulder pain effectively.
出处
《中国实用医刊》
2012年第9期7-9,共3页
Chinese Journal of Practical Medicine
关键词
胆囊切除术
腹腔镜
罗哌卡因
镇痛
Choleeystectomy
Laparoscopy
Ropivacaine
Analgesic
