摘要
目的观察术中静脉输注利多卡因对接受开腹胃癌根治术患者围手术期阿片类药物消耗量及术后早期恢复的影响。方法研究选取2024年1—11月于本院行择期开腹胃癌根治术并接受全身麻醉的患者70例,采用随机数字表法分为两组:对照组给予等量生理盐水,干预组术中持续静脉输注利多卡因,每组各35例。比较两组患者术中阿片类药物消耗量,术后2、6、12、24、48 h数字疼痛分级法(NRS)评分,同时记录术后24 h患者静脉自控镇痛(PCIA)中阿片类药物总消耗量、镇痛泵按压次数及补救镇痛需求情况,并观察术后首次下床活动时间、首次肛门排气时间及术后住院时长。此外,对围手术期不良反应发生情况进行比较分析。结果与对照组相比,干预组术中阿片类药物消耗量低于对照组,术后疼痛评分方面,干预组在术后2 h及6 h的NRS评分低于对照组(P<0.05),而术后12、24、48 h两组间差异无统计学意义(P>0.05)。此外,干预组术后24 h内PCIA相关阿片类药物总消耗量、镇痛泵自主按压次数及补救镇痛需求次数均少于对照组(P<0.05)。在术后恢复指标方面,干预组首次下床活动时间及首次排气时间均较对照组提前(P<0.05),而术后住院时间两组间差异无统计学意义(P>0.05)。围手术期不良反应发生率在两组间比较差异无统计学意义(P>0.05)。结论术中静脉输注利多卡因可以降低开腹胃癌根治术患者术中和术后早期阿片类药物消耗量,降低术后早期NRS评分,缩短术后首次下床时间和排气时间等,同时未增加不良反应。
Objective To observe the effects of intravenous lidocaine infusion on opioid consumption and early postoperative recovery in patients undergoing open gastrectomy for gastric cancer.Methods A total of 70 patients who underwent elective open radical gastrectomy with general anesthesia at our hospital from January 2024 to November 2024 were enrolled in this study.They were randomly divided into two groups using the random number table method:the control group received an equivalent amount of normal saline,while the intervention group received continuous intravenous infusion of lidocaine during surgery,with 35 patients in each group.Intraoperative opioid consumption,postoperative NRS scores at 2,6,12,24,and 48 hours,total opioid consumption via PCIA within 24 hours postoperatively,number of analgesia pump presses,and rescue analgesia requirements were compared between the two groups.Additionally,time to first ambulation,time to first flatus,and postoperative hospital length of stay were recorded,and perioperative adverse reactions were analyzed.Results The results showed that compared with the control group,the intervention group had lower intraoperative opioid consumption.Regarding postoperative pain scores,the intervention group had lower NRS scores at 2 and 6 hours postoperatively than the control group(P<0.05),while no statistically significant differences were found between the two groups at 12,24,and 48 hours postoperatively(P>0.05).Furthermore,the intervention group had lower total opioid consumption related to PCIA within 24 hours postoperatively,fewer patient-controlled analgesia pump presses,and fewer rescue analgesia requirements than the control group(P<0.05).In terms of postoperative recovery indicators,the intervention group had earlier time to first ambulation and earlier time to first flatus than the control group(P<0.05),while no statistically significant difference was found in postoperative hospital length of stay between the two groups(P>0.05).No statistically significant difference was found in the incidence of perioperative adverse reactions between the two groups(P>0.05).Conclusions Intravenous lidocaine infusion can reduce intraoperative and early postoperative opioid consumption in patients undergoing elective open gastrectomy for gastric cancer,lower early postoperative NRS pain scores,and shorten the time to first ambulation and time to first flatus without increasing adverse reactions.
作者
胡秋梅
何晓峰
HU Qiumei;HE Xiaofeng(Department of Anesthesiology,the Third Affiliated Hospital of Soochow University(the First People’s Hospital of Changzhou),Changzhou,Jiangsu 213000,China)
出处
《中国医药指南》
2026年第1期46-49,共4页
Guide of China Medicine
关键词
胃癌根治术
静脉输注利多卡因
节阿片麻醉
加速康复
Gastrectomy for gastric cancer
Intravenous lidocaine infusion
Opioid-sparing anesthesia
Enhanced recovery after surgery
