局部浸润麻醉在超普疝装置修补腹股沟疝的应用  

Application of local anaesthesia in ultra-prolene hernia system for repair of inguinal hernia

作　　者：袁柏祥 隋梁[1] 李亮[1] 

机构地区：[1]北京大学深圳医院胃肠外科,广东深圳518036

出　　处：《岭南现代临床外科》2012年第6期440-442,共3页Lingnan Modern Clinics in Surgery

摘　　要：目的探讨局部浸润麻醉下应用超普疝装置(UHS)修补腹股沟疝的手术过程中的镇痛效果。方法选择97例局部浸润麻醉下应用超普疝装置(UHS)修补腹股沟疝患者的资料。采用2%利多卡因15mL与0.75%布比卡因5mL或1%罗派卡因10mL用生理盐水稀释至60～65mL的混合液为浸润麻醉药。治疗组(n=77)在分离腹膜前间隙之前向间隙内注射以上配制的局麻药10～15mL进行浸润麻醉。对照组(n=20)未向腹膜前间隙注射局麻药。结果分离腹膜前间隙时感觉有明显疼痛的患者(NRS评分≥4):对照组为100%(20/20),治疗组为7.79%(6/77),两组差异非常显著(P<0.01);但手术操作时间、住院时间、术中出血量、术后疼痛强度、术后疼痛持续时间、术后并发症发生比例、复发情况比较,两组均无统计学差异(P>0.05)。结论腹股沟切口及腹膜前间隙局部浸润麻醉在腹股沟疝需补术中可使患者在整个手术过程中取得满意的镇痛效果。Objective To investigate a local anaesthetic method for relieving the pain during the operation of inguinal hernia repair using ultra-prolene hernia system.Methods The mixed solution,consisted of 2% lidocaine(15 mL) and 0.75% bupivacaine(5 mL) or 1% ropivacaine(10mL),was diluted to 60 to 65 mL with normal saline.Before separating preperitoneal space(Brogros space),the patients(treatment group,n=77) underwent injection of 10 to 15 mL of the local anaesthetic into the space for local infiltration(treatment group,n=77).Another 20 cases were not injected the local anaesthetic into the space(control group,n =20).Assessment of pain extent during suturing and fixing mesh was determined by numerical rating scale(NRS).Results All of controls(20 /20,100%) felt apparently pain(NRS≥4)during separating preperitoneal space,however only 6 cases in treatment group(7.79%).The operative time,length of hospital stay,blood loss,postoperative pain intensity and duration,complications,and recurrence rate had no significant differences between two groups(P >0.05).Conclusions The method that injecting the local anaesthetic into Brogros space for local infiltration during operation would alleviate the pain caused by performance of separating preperitoneal space during inguinal hernia repair.

关 键 词：腹股沟疝修补术 局部浸润麻醉 超普疝装置疼痛 

分 类 号：R614.3[医药卫生—麻醉学]