腹腔镜结直肠癌根治术后利多卡因联合舒芬太尼静脉自控镇痛的临床效果  

Clinical Effect of Patient-Controlled Intravenous Analgesia with Lidocaine Combined with Sufentanil After Laparoscopic Radical Resection of Colorectal Cancer

作　　者：张晴 王鹏程 王学飞 ZHANG Qing;WANG Peng-cheng;WANG Xue-fei(Department of Anesthesiology,Zhumadian Central Hospital,Zhumadian,Henan 463000)

机构地区：[1]河南省驻马店市中心医院麻醉科,河南驻马店463000

出　　处：《中国肛肠病杂志》2025年第2期59-61,共3页Chinese Journal of Coloproctology

摘　　要：目的:探讨腹腔镜结直肠癌根治术后利多卡因联合舒芬太尼静脉自控镇痛的效果及对肠功能恢复的影响。方法:选取2022年3月至2024年2月拟全身麻醉下行腹腔镜结直肠癌根治术的患者80例,随机分为观察组和对照组,各40例。2组患者术后均通过PCIA(经静脉病人自控镇痛)装置给药进行镇痛,但镇痛药物配置不同,观察组为利多卡因48 mg/kg、舒芬太尼2.0μg/kg、昂丹司琼16 mg加生理盐水配至300 mL,对照组为舒芬太尼2.0μg/kg、昂丹司琼16 mg加生理盐水配至300 mL。比较2组患者术后不同时间疼痛程度(VAS评分),术后48 h内PCIA装置按压次数、补救镇痛率、呕吐发生率,局麻药中毒相关不良反应发生率,术后首次排气、排便时间及住院时间。结果:与对照组相比,观察组术后6 h、12 h、24 h、36 h、48 h VAS评分均显著降低,术后48 h内PCIA装置按压次数显著减少,呕吐发生率显著降低,术后首次排气时间、排便时间及住院时间均显著缩短,差异均有统计学意义,P<0.05。2组术后48 h内补救镇痛率比较差异无统计学意义,P>0.05。2组均未发生局麻药中毒相关不良反应。结论:腹腔镜结直肠癌根治术后利多卡因联合舒芬太尼PCIA能更有效地控制术后疼痛、促进肠功能恢复。Objective To investigate the effect of patient-controlled intravenous analgesia with lidocaine combined with sufentanil on the recovery of intestinal function after laparoscopic radical resection of colorectal cancer.Methods A total of 80 patients undergoing laparoscopic radical resection of colorectal cancer under general anesthesia from March 2022 to February 2024 were randomly divided into the observation group and the control group,with 40 cases in each group.Both groups of patients were given analgesics through a PCIA(Patient-controlled intravenous analgesia)device after surgery,but the analgesic drug formulations were different.The observation group was given 48 mg/kg of lidocaine,2.0μg/kg of sufentanil,16 mg of ondansetron plus normal saline to make up to 300 mL,while the control group was given 2.0μg/kg of sufentanil,16 mg of ondansetron plus normal saline to make up to 3o0 mL.The degree of pain(VAS score)at different times after operation,the pressing times of PCIA device within 48 h after operation,the rate of rescue analgesia,the incidence rates of vomiting and adverse reactions related to local anesthetic toxicity,the first postoperative exhaust and defecation time,and the length of hospital stay were compared between the two groups.Results Compared with the control group,the VAS scores at 6 h,12 h,24 h,36 h and 48 h after operation in the observation group were significantly reduced,the pressing times of PCIA device within 48 h after operation were significantly decreased,the incidence of vomiting was significantly reduced,the first postoperative exhaust time,defecation time and hospitalization time were significantly shortened,with statistically significant differences(P<0.05).There was no significant difference in the rate of rescue analgesia within 48 h after operation between the two groups(P>0.05).No adverse reactions related to lo-cal anesthetic toxicity occurred in the two groups.Conclusion PCIA with lidocaine combined with sufentanil is more effective in controlling postoperative pain and p

关 键 词：结直肠癌 术后镇痛 利多卡因 舒芬太尼 经静脉病人自控镇痛(PCIA) 疗效 

分 类 号：R614[医药卫生—麻醉学]