Colbert S T, Moran K, O'Hanlon D M, Chambers F, Moriarty D C, Blunnie W P
Department of Anesthesia, Rotunda Hospital, Parnell Square, Dublin, Ireland.
Anesth Analg. 2000 Sep;91(3):667-70. doi: 10.1097/00000539-200009000-00032.
Patients undergoing laparoscopic procedures may experience postoperative pain. The intraperitoneal (IP) administration of drugs is controversial but has proven effective in some studies for the relief of postoperative pain. However, some investigators have not been able to confirm the analgesic efficacy of IP local anesthetics. The administration of IP opioids for the relief of postoperative pain has received little attention. At the end of laparoscopic tubal ligation, 100 patients received 80 mL of 0.125% bupivacaine with 1:200,000 epinephrine IP and 50 mg of meperidine either IP or IM. Postoperative pain scores were measured at rest and with movement. Pain scores were significantly lower in the group receiving the IP meperidine both at rest (P: < 0.01) and with movement (P: < 0.05). We conclude that the combination of intraperitoneal bupivacaine and intraperitoneal meperidine was better than the combination of IP bupivacaine and IM meperidine for postoperative analgesia in patients undergoing laparoscopic tubal ligation.
The combination of bupivacaine and meperidine delivered to the intraperitoneal cavity proved superior to equivalent doses of intraperitoneal bupivacaine and IM meperidine for postoperative pain relief in patients undergoing laparoscopic tubal ligation. Intraperitoneal delivery of analgesia proved effective in this study and merits further study and more widespread use.
接受腹腔镜手术的患者可能会经历术后疼痛。药物的腹腔内(IP)给药存在争议,但在一些研究中已证明对缓解术后疼痛有效。然而,一些研究人员未能证实腹腔内局部麻醉药的镇痛效果。腹腔内给予阿片类药物以缓解术后疼痛很少受到关注。在腹腔镜输卵管结扎术结束时,100例患者接受了80 mL含1:200,000肾上腺素的0.125%布比卡因腹腔内注射,以及50 mg哌替啶腹腔内或肌内注射。在静息和活动时测量术后疼痛评分。接受腹腔内哌替啶的组在静息时(P:<0.01)和活动时(P:<0.05)疼痛评分均显著更低。我们得出结论,对于接受腹腔镜输卵管结扎术的患者,腹腔内布比卡因和腹腔内哌替啶的联合使用在术后镇痛方面优于腹腔内布比卡因和肌内注射哌替啶的联合使用。
在接受腹腔镜输卵管结扎术的患者中,腹腔内给予布比卡因和哌替啶的联合用药在缓解术后疼痛方面被证明优于同等剂量的腹腔内布比卡因和肌内注射哌替啶。腹腔内给予镇痛药物在本研究中被证明是有效的,值得进一步研究和更广泛地应用。