中国医药
中國醫藥
중국의약
CHINA MEDICINE
2014年
10期
1505-1507
,共3页
腹腔镜胆囊切除术%肩痛%罗哌卡因%肺复张
腹腔鏡膽囊切除術%肩痛%囉哌卡因%肺複張
복강경담낭절제술%견통%라고잡인%폐복장
Laparoscopic cholecystectomy%Shoulder pain%Ropivacaine%Pulmonary recruitment manoeuvre
目的 探讨罗哌卡因局部用药联合肺复张预防腹腔镜胆囊切除术后肩痛的临床效果.方法 选取四川省雅安市中医医院2013年1月至2013年8月拟在全身麻醉下行择期腹腔镜胆囊切除手术患者90例,采用随机数字表分为对照组和观察组,每组45例.对照组患者术毕腹腔二氧化碳由穿孔器自主排出,观察组患者术后向胆囊床、肝膈间隙喷洒0.2％盐酸罗哌卡因药液,保留并开放脐下穿孔器行肺复张.观察比较2组患者术后12、24、48 h的肩痛视觉模拟评分和不良反应.结果 观察组术后12、24、48 h肩部疼痛视觉模拟评分与对照组比较,差异均有统计学意义[(1.8±1.4)分比(3.4±1.7)分,(1.9±1.5)分比(4.0±2.2)分,(1.6±1.2)分比(3.7±2.1)分](均P＜0.05).2组患者术中及术后均无局部麻醉药毒性反应.结论 局部喷洒罗哌卡因联合肺复张能有效缓解腹腔镜胆囊切除术后48 h内肩痛,且无明显不良反应发生.
目的 探討囉哌卡因跼部用藥聯閤肺複張預防腹腔鏡膽囊切除術後肩痛的臨床效果.方法 選取四川省雅安市中醫醫院2013年1月至2013年8月擬在全身痳醉下行擇期腹腔鏡膽囊切除手術患者90例,採用隨機數字錶分為對照組和觀察組,每組45例.對照組患者術畢腹腔二氧化碳由穿孔器自主排齣,觀察組患者術後嚮膽囊床、肝膈間隙噴灑0.2％鹽痠囉哌卡因藥液,保留併開放臍下穿孔器行肺複張.觀察比較2組患者術後12、24、48 h的肩痛視覺模擬評分和不良反應.結果 觀察組術後12、24、48 h肩部疼痛視覺模擬評分與對照組比較,差異均有統計學意義[(1.8±1.4)分比(3.4±1.7)分,(1.9±1.5)分比(4.0±2.2)分,(1.6±1.2)分比(3.7±2.1)分](均P＜0.05).2組患者術中及術後均無跼部痳醉藥毒性反應.結論 跼部噴灑囉哌卡因聯閤肺複張能有效緩解腹腔鏡膽囊切除術後48 h內肩痛,且無明顯不良反應髮生.
목적 탐토라고잡인국부용약연합폐복장예방복강경담낭절제술후견통적림상효과.방법 선취사천성아안시중의의원2013년1월지2013년8월의재전신마취하행택기복강경담낭절제수술환자90례,채용수궤수자표분위대조조화관찰조,매조45례.대조조환자술필복강이양화탄유천공기자주배출,관찰조환자술후향담낭상、간격간극분쇄0.2％염산라고잡인약액,보류병개방제하천공기행폐복장.관찰비교2조환자술후12、24、48 h적견통시각모의평분화불량반응.결과 관찰조술후12、24、48 h견부동통시각모의평분여대조조비교,차이균유통계학의의[(1.8±1.4)분비(3.4±1.7)분,(1.9±1.5)분비(4.0±2.2)분,(1.6±1.2)분비(3.7±2.1)분](균P＜0.05).2조환자술중급술후균무국부마취약독성반응.결론 국부분쇄라고잡인연합폐복장능유효완해복강경담낭절제술후48 h내견통,차무명현불량반응발생.
Objective To investigate the effects of local application of ropivacaine combined with pulmonary recruitment manoeuvre in the prevention of shoulder pain after laparoscopic cholecystectomy.Methods Ninety patients who underwent laparoscopic cholecystectomy at the Traditional Chinese Medicine Hospital of Yaan City,from January 2013 to August 2013,were randomly divided into observation and control group.In the control group,residual CO2 was discharged from the trocar independently at the end of surgery.However,0.2％ ropivacaine was sprayed into the gallbladder bed,liver diaphragm gap; an open umbilical trocar was reserved for the observation group.Visual analogue scale (VAS) of the shoulder pain after surgery at 12,24,48 hours and adverse reactions in both groups were monitored and measured.Results There were significant differences in the VAS of the shoulder pain after surgery at 12,24,48 hours of the observation group compared to that of the control group [(1.8±l.4)scoresvs (3.4±1.7) scores,(1.9±l.5) scores vs (4.0±2.2) scores,(1.6±l.2) vs (3.7±2.1) scores] (all P ＜ 0.05).Adverse reactions were not found in the groups,peri and post operatively.Conclusion Local spraying of ropivacaine can reduce the occurrence rate of the shoulder pain after laparoscopic cholecystectomy in 48 hours without adverse reactions.
