中国社区医师
中國社區醫師
중국사구의사
Chinese Community Doctors
2015年
27期
71-71,73
,共2页
胆囊切除术%腹腔镜%疼痛%麻醉%痛觉过敏
膽囊切除術%腹腔鏡%疼痛%痳醉%痛覺過敏
담낭절제술%복강경%동통%마취%통각과민
cholecystectomy%Laparoscope%Pain%Anesthesia%Pain hypersensitivity
目的：观察罗哌卡因胆囊三角区局部浸润用于腹腔镜胆囊切除术后镇痛的效果。方法：将择期行腹腔镜胆囊切除术患者120例随机平分为两组，对照组在胆囊分离前于胆囊三角区组织注射0.9%氯化钠注射液10 mL；试验组给予等容量0.75%盐酸罗哌卡因。记录术后2、4、6、12、24、48 h静态和动态的VAS评分；记录术后48 h内PCIA泵药物消耗量、总按压次数和有效按压次数、补救镇痛药的使用情况及不良反应的发生情况。结果：与对照组相比，试验组术后2、4、6、12、24 h静态和动态的VAS评分及48 h动态的VAS评分明显降低，PCIA总按压次数和有效按压次数、镇痛泵药物消耗量及补救镇痛药布托啡诺量均减少，镇痛不全发生率明显降低(P＜0.05或0.01)。结论：罗哌卡因胆囊三角区浸润麻醉可安全有效地用于腹腔镜胆囊切除术，进一步减轻患者术后疼痛，减少术后补救镇痛药的用量。
目的：觀察囉哌卡因膽囊三角區跼部浸潤用于腹腔鏡膽囊切除術後鎮痛的效果。方法：將擇期行腹腔鏡膽囊切除術患者120例隨機平分為兩組，對照組在膽囊分離前于膽囊三角區組織註射0.9%氯化鈉註射液10 mL；試驗組給予等容量0.75%鹽痠囉哌卡因。記錄術後2、4、6、12、24、48 h靜態和動態的VAS評分；記錄術後48 h內PCIA泵藥物消耗量、總按壓次數和有效按壓次數、補救鎮痛藥的使用情況及不良反應的髮生情況。結果：與對照組相比，試驗組術後2、4、6、12、24 h靜態和動態的VAS評分及48 h動態的VAS評分明顯降低，PCIA總按壓次數和有效按壓次數、鎮痛泵藥物消耗量及補救鎮痛藥佈託啡諾量均減少，鎮痛不全髮生率明顯降低(P＜0.05或0.01)。結論：囉哌卡因膽囊三角區浸潤痳醉可安全有效地用于腹腔鏡膽囊切除術，進一步減輕患者術後疼痛，減少術後補救鎮痛藥的用量。
목적：관찰라고잡인담낭삼각구국부침윤용우복강경담낭절제술후진통적효과。방법：장택기행복강경담낭절제술환자120례수궤평분위량조，대조조재담낭분리전우담낭삼각구조직주사0.9%록화납주사액10 mL；시험조급여등용량0.75%염산라고잡인。기록술후2、4、6、12、24、48 h정태화동태적VAS평분；기록술후48 h내PCIA빙약물소모량、총안압차수화유효안압차수、보구진통약적사용정황급불량반응적발생정황。결과：여대조조상비，시험조술후2、4、6、12、24 h정태화동태적VAS평분급48 h동태적VAS평분명현강저，PCIA총안압차수화유효안압차수、진통빙약물소모량급보구진통약포탁배낙량균감소，진통불전발생솔명현강저(P＜0.05혹0.01)。결론：라고잡인담낭삼각구침윤마취가안전유효지용우복강경담낭절제술，진일보감경환자술후동통，감소술후보구진통약적용량。
Objective:To observe the effect of ropivacaine local infiltration of Calot triangle for analgesia after laparoscopic cholecystectomy.Methods:120 patients with the elective laparoscopic cholecystectomy were randomly divided into the two groups. Patients in the control group were injected with 0.9% saline 10 mL at the Calot triangle before the gallbladder was isolated. Patients in the experimental group were given equal volume of 0.75% ropivacaine.The static and dynamic VAS scores of 2,4,6,12, 24,48 h were recorded.We record the drug consumption of PCIA pump within 48 h after operation,the total press times and effective press times,the use of the remedy for analgesics and the occurrence of adverse reactions.Results:The static and dynamic VAS scores of 2,4,6,12,24 h and the dynamic VAS score of 48 h of the control group were significantly decreased compared with the control group;the total press times and the number of effective press times of PCIA,drug consumption of analgesic pump and the amount of remedy analgesic butorphanol were all decreased;the incidence of analgesia was significantly lower(P<0.05 or 0.01).Conclusion:Ropivacaine infiltration anesthesia of Calot triangle can be used safely and effectively in laparoscopic cholecystectomy.It can further reduce postoperative pain,and reduce the dosage of postoperative relief for analgesics.
