静脉输注利多卡因对腹腔镜下胃减容手术患者术后疼痛及早期恢复的影响  

Effect of Intravenous Infusion of Lidocaine on Postoperative Pain and Early Recovery in Patients Undergoing Laparoscopic Bariatric Surgery

作　　者：孙静 王磊 王光磊 SUN Jing;WANG Lei;WANG Guanglei(Affiliated Hospital of Xuzhou Medical University,Jiangsu 221000,China)

机构地区：[1]徐州医科大学附属医院麻醉科,221000

出　　处：《医学研究杂志》2022年第9期167-170,共4页Journal of Medical Research

摘　　要：目的 探讨静脉输注利多卡因对接受胃减容术患者术后镇痛及早期恢复的影响。方法 选取104例ASA分级Ⅱ~Ⅲ级、行择期全身麻醉下腹腔镜胃减容术的肥胖患者,按照随机数字表法分为两组,即利多卡因组(L组)和对照组(C组)。利多卡因组在诱导前,静脉输注利多卡因1.5mg/kg,随后以2mg/(kg·h)的速度泵注直至手术结束。对照组等体积0.9%NaCl注射液给予负荷剂量并泵注。主要结局指标:术后0、6、12、24h安静及咳嗽VAS,并记录术后24h的恢复质量-40(QoR-40问卷)评分、术中丙泊酚及瑞芬太尼消耗量、胃肠道功能恢复情况、首次下床活动时间、术后24h内地佐辛使用情况、术后住院时间、不良反应发生率等。结果 利多卡因组术后6、12、24h的静息状态及咳嗽时VAS低于对照组(P均<0.05),并且围术期阿片类药物用量更少(P均<0.05),术后24h QoR-40评分更高(P均<0.001)。结论 静脉输注利多卡因可减少胃减容术患者术中、术后镇痛药用量及恶心、呕吐发生,有助于胃肠功能恢复,有利于患者的早期恢复。Objective To investigate the effect of intravenous infusion of lidocaine on postoperative analgesia and early recovery in patients undergoing bariatric surgery. Methods 104 obese patients with ASA class Ⅱ-Ⅲ who underwent elective laparoscopic bariatric surgery were divided into two groups according to the random number table method: lidocaine group(group L) and control group(group C).For group L, loading dose of lidocaine was given intravenously at 1.5 mg/kg during induction, followed by pumping at 2 mg/(kg·h) until the end of operation. For group C, load dose and pumping with equal volume 0.9% sodium chloride solution was given. Main outcome indicators were VAS scores at 0 h, 6 h, 12 h, 24 h postoperatively during quiet and coughing, and QoR-40 scores at 24 h postoperatively, intraoperative propofol and remifentanil consumption, time to first postoperative gas, first defecation, time to bed activity, use of remedial analgesic drugs at 24 h postoperatively, length of hospital stay, and adverse effects were recorded. Results Compared with group C, group L had lower VAS scores at 6 h, 12 h and 24 h postoperatively during quiet and coughing(all P<0.05), less intraoperative and postoperative opioid use(all P<0.05), and higher QoR-40 scores at 24 hours postoperatively(all P<0.001). ConclusionIntravenous infusion of lidocaine provided good postoperative analgesia for patients with laparoscopic bariatric surgery, promoted recovery of gastrointestinal function, reduced the incidence of nausea and vomiting, and facilitated early recovery.

关 键 词：利多卡因 胃减容术 术后疼痛 术后恢复 

分 类 号：R614[医药卫生—麻醉学]