Jiranantarat Vorakran, Rushatamukayanunt Winchai, Lert-akyamanee Narong, Sirijearanai Rattapol, Piromrat Isariya, Suwannanonda Pudsadee, Muangkasem Jarinya
Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
J Med Assoc Thai. 2002 Sep;85 Suppl 3:S897-903.
To study the effectiveness of intraperitoneal instillation of bupivacaine for postoperative laparoscopic cholecystectomy pain relief, especially specific pain (visceral pain, shoulder pain and epigastric pain).
Eighty ASA (American Society of Anesthesiologists) 1 and 2 patients were randomly assigned to receive either 20 ml of 0.5 per cent bupivacaine (n=39) or the same volume of saline (n=41) instilled under direct vision into the hepatodiaphragmatic space, near and above the hepatoduodenal ligament and above the gall bladder bed at the end of surgery. The intensity of visceral pain, shoulder pain and epigastric pain was assessed at 1, 6, 24 and 48 h after surgery using a visual analogue scale (100 mm VAS) and verbal rating "Prince Henry" pain scale (VRS). The time when analgesia was first required and total analgesic consumption were also recorded. t-test, Chi-square, Mann-Whitney U test and Kaplan-Meier survival analysis were used for statistical analysis.
Patient data were similar in the two groups except for body weight. There were no statistical differences between the two groups for the time when analgesia was first' required, VAS, VRS and total analgesic consumption.
In this study, intraperitoneal instillation of bupivacaine does not show any advantage for postoperative analgesia after laparoscopic cholecystectomy.
研究布比卡因腹腔内注入对腹腔镜胆囊切除术后疼痛缓解的有效性，尤其是特定疼痛（内脏痛、肩痛和上腹部疼痛）。
80例美国麻醉医师协会（ASA）1级和2级患者被随机分配，分别于手术结束时在直视下向肝膈间隙、肝十二指肠韧带附近及上方、胆囊床上方注入20 ml 0.5%布比卡因（n = 39）或等量生理盐水（n = 41）。术后1、6、24和48小时，使用视觉模拟评分法（100 mm VAS）和言语评分“亨利王子”疼痛量表（VRS）评估内脏痛、肩痛和上腹部疼痛的强度。记录首次需要镇痛的时间和总镇痛药物消耗量。采用t检验、卡方检验、曼-惠特尼U检验和Kaplan-Meier生存分析进行统计分析。
除体重外，两组患者数据相似。两组在首次需要镇痛的时间、VAS、VRS和总镇痛药物消耗量方面无统计学差异。
在本研究中，布比卡因腹腔内注入对腹腔镜胆囊切除术后镇痛无任何优势。
