摘要
目的探讨双氯芬酸钠盐酸利多卡因注射液超前镇痛用于腹腔镜手术患者的安全性和有效性。方法 2011年12月～2012年3月,选择ASAⅠ～Ⅱ级,择期行腹腔镜手术的患者50例,按手术通知单顺序编号,依次交替分为实验组和对照组,每组25例,均采用全凭静脉麻醉,诱导前10 min实验组臀部肌肉注射双氯芬酸钠盐酸利多卡因注射液2 ml,对照组不做处理,术后2 h(T2)、6 h(T6)、12 h(T12)、24 h(T24)用视觉模拟评分法(VAS)进行疼痛评分和布氏评分法(BCS)进行舒适评分,并记录术后不良反应发生情况。结果 2组麻醉苏醒时间差异无显著性(P>0.05)。实验组术后24 h内各时点VAS评分及BCS评分显著优于对照组(P<0.05)。与对照组相比,实验组苏醒期躁动发生例数少(2例vs.9例,χ2=5.711,P=0.017),追加镇痛的例数少(3例vs.10例,χ2=5.094,P=0.024)。2组术后恶心呕吐差异无显著性(P>0.05)。结论双氯芬酸钠盐酸利多卡因注射液超前镇痛用于腹腔镜手术患者,可明显减轻术后疼痛,减少镇痛药的使用及苏醒期烦躁,且给药方便,不良反应少,可以安全用于临床。
Objective To explore the safety and efficacy of preemptive analgesia with diclofenac sodium and lidocaine hydrochloride injection in patients undergoing gynaecological laparoscopic operation. Methods Fifty patients with ASA I - II were schedulced for laparoseopic operation according to surgery notice sequentially numbered from December 2011 to March 2012. They were alternately divided into two groups ： the treated group （ n = 25 ） and the control group （ n = 25 ）. Each group of 25 cases were using total intravenous anesthesia. Before induction, the treated group received diclofenac sodium and lidocaine hydrochloride injection of 2 ml,and the control group remained untreated. The effect of analgesia was accessed by visual analog scale（VAS） and the easement score was accessed by BCS at 2 h, 6 h, 12 h and 24 h after surgery. Side effects were also recorded. Results No significant difference was observed between the two groups in postoperative recovery time （P 〉 0.05 ）. Compared with the control group, the treated group showed significantly better VAS and BCS in 24 hours after the operation （P 〈 0.05）. A significant reduction in the number of patients＇ restlessness was found as compared with the control group （2 cases vs. 9 cases, X2 = 5. 711 ,P = 0. 017） , and significantly less cases of additional analgesia were observed in the treated group （3 cases vs. 10 cases, X2 = 5. 094,P = 0. 024）. No significant difference was observed between the two groups in PONV（P 〉 0.05 ）. Conclusion Preemptive analgesia with diclofenac sodium and lidocaine hydrochloride injection in patients who underwent laparoscopie operation can obviously alleviate postoperative pain, reduce the use of analgesic and the incidence of restlessness of patients with fewer side effects, therefore we conclude it can be safely used in clinical practice.
出处
《中国微创外科杂志》
CSCD
2013年第5期429-431,共3页
Chinese Journal of Minimally Invasive Surgery
关键词
非甾体抗炎镇痛药
双氯芬酸钠盐酸利多卡因注射液
超前镇痛
腹腔镜
Nonsteriodal anti-inflammatory drugs
Diclofenac sodium and lidocaine hydrochloride injection
Preemptiveanalgesia
Laparoscope
