术前术后切口注射布比卡因对腹腔镜附件切除术后疼痛的影响  

Effects of bupivacaine infiltration at preoperative or postoperative on postoperative pain after laparoscopic adnexectomy

作　　者：邱国美[1] 何尧[1] 丁洁岚[1] 冯娟[1] 

机构地区：[1]绍兴市妇幼保健院,浙江绍兴312000

出　　处：《浙江医学教育》2014年第1期51-53,共3页Zhejiang Medical Education

摘　　要：目的:探讨术前术后切口注射布比卡因对腹腔镜附件切除术后疼痛的影响。方法:选取120例附件切除患者随机分为A、B、C 3组,每组40例。A组:手术切皮前5min切口全层预注0.25%布比卡因。B组:在手术结束缝皮前切口全层注射0.25%布比卡因。C组:患者不用任何局麻药物。观察3组患者手术后1h、3h、6h、12h、24h、48h安静时疼痛视觉模拟评分(VAS)。结果:A、B2组在术后1h、3h、6h、12h、24h各时间点VAS评分均显著低于C组(P<0.05);A组6h、12hVAS评分显著低于B组(P<0.05)。结论:手术前或手术后患者切口用0.25%布比卡因局部浸润可以显著减轻腹腔镜附件切除术患者术后切口的疼痛,且术前布比卡因局部浸润麻醉对术后切口镇痛效果在某些时间点可能较术后使用布比卡因更有效。[ Objective] To investigate whether bupivacaine infiltration at preoperative or postoperative can decrease postoperative pain after laparoscopic adnexectomy. [ Method]A total of 120 cases of laparoscopic adnexectomy patients were randomly divid- ed into three groups with 40 cases each. Each incision sites were infiltrated with 0.25 % bupivacaine at five minutes before inci- sion （group A） or before suture （group B）. Group C was not given bupivacaine infillration as the control. The visual analogue scale （VAS） on patients in quiet condition after 1, 3, 6, 12, 24, and 48 hours from operation were observed respectively. [ Result ] The results of the following figures in group A and group B were significantly lower than those in group C （ P 〈 0. 05） ： VAS scors after 1, 3, 6, 12 and 24 hours from the operation. VAS scores in group A were significantly less than those in group B at 6h and 12h after operation（ P 〈 0.05）. [ Conclusion] The infiltration of 0.25% bupivacalne before incision or be- fore suture can effectively decrease postoperative incision pain. The infiltration before incision maybe is more effective than be- fore suture.

关 键 词：腹腔镜附件切除术 布比卡因 镇痛 局部浸润麻醉 

分 类 号：R713[医药卫生—妇产科学]