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| 静脉输注利多卡因对腹腔镜全子宫切除术患者镇痛效果的影响 |
| Effect of intravenous infusion of lidocaine on postoperative analgesia in patients undergoing laparoscopic total hysterectomy |
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| DOI：10.12089/jca.2017.12.1159 |
| 中文关键词: 利多卡因 腹腔镜 术后疼痛 镇痛 |
| 英文关键词: Lidocaine Laparoscopy Postoperative pain Analgesia |
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| 中文摘要: |
目的 观察静脉输注利多卡因对腹腔镜全子宫切除术患者术后镇痛效果的影响。
方法 选择我院择期全麻下行腹腔镜全子宫切除术患者80例,年龄28～65岁, 体重42～76 kg,ASA Ⅰ或Ⅱ级,采用随机数字表法将患者随机分为利多卡因组(L组)和对照组(C组), 每组40例。L组于麻醉诱导前静脉注射利多卡因1.5 mg/kg, 随后以2 mg·kg-1·h-1的速度持续输注至手术结束, C组以同样方法 静脉输注等容量生理盐水100 ml。术毕两组患者均使用舒芬太尼自控静脉镇痛, 维持VAS评分≤3分。分别于术后2、4、8、12、24和48 h行Ramsay镇静评分和BCS舒适度评分, 记录患者术后24 h舒芬太尼用量、额外追加舒芬太尼用量、自控镇痛次数、术后首次排气、排便时间、恶心、呕吐发生情况以及住院时间。
结果 与C组比较, L组患者术后2、4、8、12和24 h的Ramsay镇静评分和BCS舒适度评分明显升高（P<0.05）, 术后24 h舒芬太尼用量[(34.8±5.8)μg vs (49.8±12.5)μg]、额外追加舒芬太尼用量[(22.5±2.6) μg vs (46.2±3.8)μg]、自控镇痛次数[(20±4)次 vs (48±6)次]明显减少(P<0.05), 术后首次排气[(17±6) h vs (27±7) h]、排便时间 [(26±8) h vs (47±9) h]以及住院时间[(4.5±0.5) d vs (5.6±0.8) d]明显缩短(P<0.05), 术后恶心[2例(5%) vs 8例(20%)]明显减少(P<0.05)。
结论 静脉输注利多卡因可提高腹腔镜下全子宫切除术患者术后镇痛效果, 节俭术后阿片类镇痛药物的用量, 促进患者术后肠道功能的恢复, 缩短患者住院时间。 |
| 英文摘要: |
Objective To investigate the effect of intravenous infusion of lidocaine on postoperative analgesia in patients undergoing laparoscopic total hysterectomy.
Methods Eighty patients aged 28-65 years undergoing laparoscopic total hysterectomy were randomly divided into 2 groups (n=40 each): lidocaine group (group L) and control group (group C). In group L, patients assigned to received an intravenous bolus infusion of 1.5 mg/kg of lidocaine, then followed by 2 mg·kg-1·h-1 until the end of operation. Group C received an equal volume of normal saline (100 ml). The patients received patient-controlled intravenous analgesia (PCIA) of sufentanil after surgery, maintaining VAS score≤3. The Ramsay sedation scores and Bruggrmann comfort scale (BCS) at 2, 4, 8, 12, 24 and 48 h after operation were recorded. The consumption of sufentanil within 24 h after operation, the dose of extra sufentanil, the number of delivered doses, the times of postoperative firstly flatus and defecation, the incidence of postoperative nausea and vomiting, and total hospital stay were also observed.
Results Compared with group C, the Ramsay sedation scores and BCS was increased, the consumption of sufentanil within 24 h after operation [(34.8±5.8)μg vs (49.8±12.5)μg], the dose of extra sufentanil [(22.5±2.6)μg vs (46.2±3.8)μg], the number of delivered doses [(20±4)times vs (48±6)times] was significantly decreased (P<0.05), the time of postoperative firstly flatus [(17±6)h vs (27±7)h] and defecation [(26±8)h vs (47±9)h] and total hospital stay [(4.5±0.5)d vs (5.6±0.8)d] was significantly shortened (P<0.05), and the incidence of postoperative nausea (5% vs 20%) were significantly decreased (P<0.05) in group L.
Conclusion Intravenous infusion of lidocaine can enhance postoperative analgesia and reduce the volume of opioid analgesics, and was beneficial for peristalsis and hospital for patients undergoing laparoscopic total hysterectomy. |
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