罗哌卡因局部麻醉减轻腹腔镜胆囊切除术后疼痛的临床观察  

Clinical use of local ropivacaine in laparoscopic cholecystectomy

作　　者：柯敬东[1] 韩威[2] 郑飞[2] 田鸣[1] 

机构地区：[1]首都医科大学附属北京友谊医院麻醉科,100050 [2]首都医科大学附属北京友谊医院外科,100050

出　　处：《临床麻醉学杂志》2011年第6期555-557,共3页Journal of Clinical Anesthesiology

摘　　要：目的观察腹腔镜胆囊切除术后应用罗哌卡因行局部麻醉对术后疼痛的缓解作用。方法 90例实施腹腔镜胆囊切除术患者,随机均分为三组:Ⅰ组用1%罗哌卡因10 ml进行胆囊床喷洒;Ⅱ组用1%罗哌卡因5 ml进行胆囊床喷洒,同时再用1%罗哌卡因5 ml对三个切口进行局部注射,Ⅲ组为对照组。记录术后1、2、4、6、12、24 h的VAS。结果术后1、2、4 h时,Ⅰ组和Ⅱ组的VAS显著低于Ⅲ组(P<0.05),且Ⅱ组的VAS显著低于I组(P<0.05)。术后6 h时,Ⅰ组和Ⅱ组的VAS显著低于Ⅲ组(P<0.05),Ⅰ组和Ⅱ组差异无统计学意义。术后Ⅲ组需要哌替啶镇痛的患者数量显著多于Ⅰ组和Ⅱ组(P<0.05)。结论罗哌卡因局部麻醉能显著减轻腹腔镜胆囊切除术后疼痛。Objective To investigate the effect of local ropivacaine in laparoscopic cholecystectomy. Methods Ninety patients undergoing laparoscopic cholecystectomy were randomized to three groups with thirty patients each., group Ⅰ received 1% ropivacaine 10 ml irrigated gallbladder fossa; group Ⅱ received 1% ropivacaine 5 ml irrigated gallbladder fossa and additional 5 ml to infiltrate incision; group Ⅲ as control group. Postoperative pain was rated at 1,2,4,6,12, and 24 h after surgery. Results At 1,2,and 4 h after surgery, the VAS scores of group Ⅰ and Ⅱ was lower than group Ⅲ （P〈0. 05）, and it was more significant in group Ⅲ. The VAS scores of group Ⅱ and Ⅲ was lower than group Ⅲ 6 h after surgery（P〈0, 05）,but there was no significant difference between group Ⅰ and group Ⅱ. The amount of pethidine requirements of group Ⅲ was more than the other groups （P〈0. 01）. Conclusion Local use of ropivacaine can significantly reduce postoperative pain after laparoscopic cholecystectomy.

关 键 词：腹腔镜胆囊切除术 术后镇痛 罗哌卡因 

分 类 号：R614[医药卫生—麻醉学]