Readman Emma, Maher Peter J, Ugoni Antony M, Gordon Simon
Department of Endosurgery, Mercy Hospital for Women, Clarendon Street, East Melbourne, Victoria 3002, Australia.
J Am Assoc Gynecol Laparosc. 2004 Nov;11(4):486-91. doi: 10.1016/s1074-3804(05)60080-1.
To assess the benefits of the combination of a gas drain and the instillation of local anesthetic on the incidence of pain after operative gynecologic laparoscopy.
Randomized control trial (Canadian Task Force classification I).
Tertiary referral center.
One hundred twenty-eight patients undergoing operative gynecologic laparoscopy procedures lasting less than 105 minutes.
Postoperatively, one group received a blocked drain and saline placed intraperitoneally; a second group was given a blocked drain and ropivacaine; a third group received a patent drain and saline; and a fourth was given a patent drain and ropivacaine.
Visual analogue pain scores (VAS) were measured at 1, 2, 4, and 12 hours and day 1 to day 7. Also measured was opioid consumption at 4 hours, nausea, and activity scores. We found a statistically significant improvement in pain scores at 2 and 4 hours in the group allocated to receive a patent drain and ropivacaine.
We recommend the use of a gas drain and ropivacaine to reduce postoperative pain.
评估气体引流与局部麻醉药注入联合使用对妇科腹腔镜手术后疼痛发生率的益处。
随机对照试验（加拿大工作组分类I级）。
三级转诊中心。
128例接受持续时间少于105分钟的妇科腹腔镜手术的患者。
术后，一组接受封闭引流管并腹腔内注入生理盐水；第二组接受封闭引流管并注入罗哌卡因；第三组接受开放引流管并注入生理盐水；第四组接受开放引流管并注入罗哌卡因。
在术后1、2、4、12小时以及第1天至第7天测量视觉模拟疼痛评分（VAS）。同时测量4小时时的阿片类药物消耗量、恶心情况及活动评分。我们发现，分配接受开放引流管并注入罗哌卡因的组在术后2小时和4小时的疼痛评分有统计学意义的显著改善。
我们建议使用气体引流和罗哌卡因以减轻术后疼痛。
