复方利多卡因乳膏对内镜下套扎痔疮患者术后镇痛效应的影响  

Clinical application of compound lidocaine cream after hemorrhoid ligation under endoscope

作　　者：吕国恩 陈学清 彭亮 邹文书[1] 谭翠[1] LV Guo-en;CHEN Xue-qing;PENG Liang(Jiangmen Central Hospital Camera Center,Jiangmen 529000,China)

机构地区：[1]江门市中心医院窥镜中心,广东江门529000

出　　处：《中国处方药》2023年第3期120-123,共4页Journal of China Prescription Drug

摘　　要：目的观察复方利多卡因乳膏对内镜下套扎痔疮患者术后镇痛效应的影响。方法将135例在消化内镜中心行内镜下痔疮套扎术的患者随机分为3组,A组、B组和L组,每组均45例,A组在术毕清醒后给予口服美洛昔康镇痛,B组患者给予盐酸曲马多注射液静脉镇痛,L组在肛外周表面均匀涂抹复方利多卡因乳膏镇痛。记录3组患者的术前、用药后1 h、6 h及24 h后的疼痛(numerical rating scale,NRS)评分,术前和术后24 h心境状况(profile of mood states,POMS)评分及24 h内可能出现的高血压、心动过速、尿潴留、局部瘙痒等不良反应及三组综合满意度评级。结果与术前比较,术后三组POMS评分均升高(P<0.05),A组用药后1 h、6 h及24 h和B组用药后1 h的NRS疼痛评分较术前升高(P<0.05);与A组比较,B组、L组用药后不同时间点的NRS疼痛评分均低于A组(P<0.05);与B组比较,L组患者用药后1 h和24 h的NRS疼痛评分更低(P<0.05),但用药后6 h两组NRS疼痛评分差异无统计学意义。L组患者在术后不良反应发生率均较A组和B组低,组间比较差异有统计学意义(P<0.05)。三组综合满意度评级L组>B组>A组,组间比较差异有统计学意义(P<0.05)。结论复方利多卡因乳膏对内镜下套扎痔疮患者术后镇痛安全有效,减轻痔疮术后疼痛,且不良反应发生率低。Objective To observe the analgesic effect of compound lidocaine cream in patients after hemorrhoids ligation under endoscope.Methods 135 patients with hemorrhoids underwent endoscopic ligation in the digestive endoscopy center of our hospital were randomly divided into three groups,group A,group B and group L,with 45 cases in each group.Group A was given oral meloxicam for analgesia after the operation,and group B was given tramadol hydrochloride injection for intravenous analgesia.In group L,compound lidocaine cream was evenly smeared on the peripheral surface of anus.The numerical rating scale(NRS)scores before operation,1 h,6 h and 24 h after operation,and profile of mood states before and after operation were recorded and analyzed statistically.The possible adverse reactions such as hypertension,tachycardia,urinary retention and local pruritus within 24 hours were recorded,and the comprehensive satisfaction rating of the three groups was also recorded.Results Compared with preoperative,POMS scores of three groups were increased(P<0.05),NRS pain scores at 1 h,6 h,24 h in group A and 1 h after treatment in group B were higher than those before operation(P<0.05).Compared with group A,the NRS pain scores of group B and group L at different time points were lower than those of group A,and the difference was significant(P<0.05).Compared with group B,patients in the group L had lower NRS pain scores at 1 h and 24 h after treatment(P<0.05),but there was no significant difference in NRS pain scores between the two groups at 6 h after treatment.The incidence of postoperative adverse reactions in group L was lower than that in the group A and group B,and there was statistical significance(P<0.05).The comprehensive satisfaction rating of the three groups was group L>group B>group A,and the difference was statistically significant(P<0.05).Conclusion Local application of compound lidocaine cream is safe and effective for postoperative analgesia in patients with endoscopic ligation of hemorrhoids.It can reduce postoperative

关 键 词：复方利多卡因乳膏 内镜下套扎 痔疮 镇痛 

分 类 号：R614[医药卫生—麻醉学]