中华麻醉学杂志
中華痳醉學雜誌
중화마취학잡지
CHINESE JOURNAL OF ANESTHESIOLOGY
2012年
4期
430-432
,共3页
药物投予系统%酰胺类%疼痛,手术后%镇痛%炎症
藥物投予繫統%酰胺類%疼痛,手術後%鎮痛%炎癥
약물투여계통%선알류%동통,수술후%진통%염증
Drug delivery systems%Amides%Pain,postoperative%Analgesia%Inflammation
目的 评价持续切口灌注罗哌卡因术后镇痛对局部炎症反应的影响.方法 拟行单纯性肾脏切除术病人40例,ASA分级Ⅰ级或Ⅱ级,年龄45～64岁,体重45～80 kg,性别不限.采用随机数字表法,将病人随机分为2组:对照组(C组)及持续切口灌注局麻药组(CWI组),每组20例.CWI组持续切口灌注0.25％罗哌卡因,C组灌注等容量生理盐水,并采用静脉吗啡病人自控镇痛辅助镇痛.于术后6、12、24及48h,分别记录吗啡累积用量,采用ELISA法检测引流液中前列腺素E2(PGE2)浓度.结果 与C组比较,CWI组术后各时段吗啡累积用量降低,术后各时点引流液PGE2浓度降低(P＜0.05).结论 持续切口灌注罗哌卡因镇痛效应机制与抑制切口局部炎症反应有关.
目的 評價持續切口灌註囉哌卡因術後鎮痛對跼部炎癥反應的影響.方法 擬行單純性腎髒切除術病人40例,ASA分級Ⅰ級或Ⅱ級,年齡45～64歲,體重45～80 kg,性彆不限.採用隨機數字錶法,將病人隨機分為2組:對照組(C組)及持續切口灌註跼痳藥組(CWI組),每組20例.CWI組持續切口灌註0.25％囉哌卡因,C組灌註等容量生理鹽水,併採用靜脈嗎啡病人自控鎮痛輔助鎮痛.于術後6、12、24及48h,分彆記錄嗎啡纍積用量,採用ELISA法檢測引流液中前列腺素E2(PGE2)濃度.結果 與C組比較,CWI組術後各時段嗎啡纍積用量降低,術後各時點引流液PGE2濃度降低(P＜0.05).結論 持續切口灌註囉哌卡因鎮痛效應機製與抑製切口跼部炎癥反應有關.
목적 평개지속절구관주라고잡인술후진통대국부염증반응적영향.방법 의행단순성신장절제술병인40례,ASA분급Ⅰ급혹Ⅱ급,년령45～64세,체중45～80 kg,성별불한.채용수궤수자표법,장병인수궤분위2조:대조조(C조)급지속절구관주국마약조(CWI조),매조20례.CWI조지속절구관주0.25％라고잡인,C조관주등용량생리염수,병채용정맥마배병인자공진통보조진통.우술후6、12、24급48h,분별기록마배루적용량,채용ELISA법검측인류액중전렬선소E2(PGE2)농도.결과 여C조비교,CWI조술후각시단마배루적용량강저,술후각시점인류액PGE2농도강저(P＜0.05).결론 지속절구관주라고잡인진통효응궤제여억제절구국부염증반응유관.
Objective To investigate the effects of continuous wound infusion of ropivacaine for postoperative analgesia on local inflammation.Methods Forty ASA Ⅰ or Ⅱ patients,aged 45-64 yr,weighing 45-80 kg,undergoing simple nephrectomy,were randomized into either continusous wound infusion of local anesthetic group ( group CWI ) or control group ( group C),with 20 cases each.Group CWI were treated with continuous wound infusion of 0.25％ ropivacaine for postoperative analgesia,while group C were infused with the same volume of normal saline.All patients received patient-controlled analgesia with intravenous morphine.At 6,12,24 and 48 h after operation,the accumulated consumption of morphine was documented,and the concentration of prostaglandinE2 (PGE2) of drainage was determined using ELISA.Results Compared with group C,the accumulated consumption of morphine was decreased,and the PGE2 concentration was decreased in group CWI at each time points.Conclusion The mechanism of postoperative analgesic effect of continuous wound infusion of ropivacaine is related to the suppression of local inflammation in wound sites.
