摘要
目的探讨腹腔镜胆囊切除术后,腹腔及切口内注入罗哌卡因的镇痛效果。方法80例胆囊腹腔镜切除术患者随机分为对照组和实验组,实验组患者行胆囊切除术前先向胆囊表面喷0.5%罗哌卡因6mL,术毕再向胆囊床及肝膈间隙喷洒12mL,缝合腹壁切口前向每个切口局部注入相同药液4mL;对照组为空白对照。观察术中胆-心反射发生情况,术后0、2、6、12和24h行VSA评分,记录术后患者右上腹、右肩背疼痛及腹壁切口疼痛、镇静情况及术后恶心呕吐反射。结果术中实验组无胆-心反射发生,对照组发生8例(20%)。与对照组比较,实验组患者右上腹、右肩背疼痛及腹壁切口疼痛VAS评分,在术后12h内各个时间点差异显著(P<0.05),而12～24h时VAS评分无差异(P>0.05)。两组患者均无呼吸抑制发生,恶心、呕吐、瘙痒和眩晕的发生率无差异(P>0.05)。结论腹腔镜胆囊切除术前后,腹腔及切口喷洒罗哌卡因对防止术中胆心反射的发生及减轻术后疼痛有良好效果,值得推广。
【Objective】To study the analgesic effect of spraying ropivacaine after laparoscopic cholecystectomy. 【Methods】Totally 80 cases receiving laparoscopic gallbladder surgery were randomly divided into control group and experimental group. The patients in experimental group had the first spray of 6 mL 0.5% ropivacaine onto gallbladder surface before cholecystectomy, additional spray of 12 mL to the gallbladder bed and hepato-diaphramatic space after operation, and pray of 4 mL to abdominal incisions before suture. The control group was the blank control. The occurrence of guts-cardiac reflex was observed. The VSA scores at 0, 2, 6, 12 and 24 h after operation were evaluated. The pain of right upper quadrant, right shoulder and back, abdominal incision was recorded, the sedation effect and postoperative nausea and vomiting reflex were observed. 【Results】The experimental group did not have biliarycardiac reflex while eight cases in the control group （20%） did, the difference had statistical significance （P 0.05）. the VAS scores of the experimental group at different time points within 12 h were statistically different from those of the control group （P 0.05）, and those from 12 h to 24 h had no statistical difference （P 0.05）. In both groups, patients had no respiratory depression; the incidences of nausea, vomiting, itching and vertigo were of no significant difference （P 0.05）. 【Conclusion】Spraying ropivacaine before and after laparoscopic cholecystectomy can effectively prevent the occurrence of cardiac reflex and reduce postoperative pain, is worthy to be popularized
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2010年第4期587-588,591,共3页
China Journal of Modern Medicine
关键词
腹腔镜胆囊切除术
耐乐品
胆心反射
恶心
呕吐
术后镇痛
laparoscopic cholecystectomy
ropivacaine
biliary-cardiac reflex
nausea
vomiting
postoperative analgesia
