Noma H, Kakiuchi H, Nojiri K, Izumi R, Tashiro C
Department of Anesthesiology, Takarazuka City Hospital, Takarazuka 665-0827.
Masui. 2001 Nov;50(11):1201-4.
We compared the analgesic effect of bupivacaine infiltration into surgical wounds with that of epidural block after laparoscopic cholecystectomy (LC). Forty-five patients (ASA physical status I-II) for LC were randomized into three groups (n = 15 in each group). Patients received only general anesthesia (Group C), received infiltration of 0.5% bupivacaine into the surgical wound before surgery combined with general anesthesia (Group L), or received epidural anesthesia combined with general anesthesia (Group E). Postoperative pain was assessed using visual analogue scale (scale: 0-10) at 1, 2, 6 and 12 hours after the operation, the need for additional supplemental analgesics, and the cost of anesthesia. Visual analogue scale in Group C at 1, 2, or 6 hours was significantly greater than that of Group L and E. The number of patients who needed supplemental analgesics was 9 in Group C, 5 in Group L, and 2 in Group E. The cost of pharmaceutical and anesthetic practice of Group E was more expensive than Group L and C. In conclusion, infiltration of bupivacaine combined with general anesthesia is an effective and economical method of postoperative pain relief.
我们比较了布比卡因浸润手术伤口与腹腔镜胆囊切除术(LC)后硬膜外阻滞的镇痛效果。45例拟行LC的患者(ASA身体状况I-II级)被随机分为三组(每组n = 15)。患者仅接受全身麻醉(C组),术前在手术伤口处浸润0.5%布比卡因并联合全身麻醉(L组),或接受硬膜外麻醉并联合全身麻醉(E组)。术后分别于术后1、2、6和12小时使用视觉模拟评分法(评分范围:0-10)评估疼痛程度、额外补充镇痛药的需求以及麻醉费用。C组在术后1、2或6小时的视觉模拟评分显著高于L组和E组。需要补充镇痛药 的患者人数在C组为9例,L组为5例,E组为2例。E组的药物和麻醉操作费用高于L组和C组。总之,布比卡因浸润联合全身麻醉是一种有效且经济的术后镇痛方法。