Wu Christopher L, Partin Alan W, Rowlingson Andrew J, Kalish Murray A, Walsh Patrick C, Fleisher Lee A
Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland 21287, USA.
Urology. 2005 Aug;66(2):366-70. doi: 10.1016/j.urology.2005.02.030.
To determine whether a subfascial continuous infusion of local anesthetic in patients undergoing radical retropubic prostatectomy would result in a reduction in postoperative opioid requirements and an improvement in pain scores.
This was a prospective, double-blind, placebo-controlled, randomized trial in patients undergoing elective radical retropubic prostatectomy. A small catheter was placed subfascially at the end of surgery and attached to an elastomeric pump that administered either 0.5% bupivacaine or normal saline into the wound at a rate of 2 mL/hr until discharge on postoperative day 3. The outcomes assessed included the dosage of hydromorphone used by a patient-controlled analgesic system, a visual analog scale (VAS) for pain at rest and with activity, a VAS of nausea, and length of hospital stay.
A total of 100 patients were successfully randomized, with all patients completing the protocol. No differences were found between the groups with regard to VAS pain at rest, VAS pain with activity, intravenous or oral analgesic consumption, or VAS nausea scores.
Continuous subfascial infusion of local anesthetic did not result in a postoperative reduction in opioid requirements or an improvement in pain scores in patients undergoing radical retropubic prostatectomy.
确定在耻骨后根治性前列腺切除术患者中，筋膜下持续输注局部麻醉药是否会降低术后阿片类药物需求量并改善疼痛评分。
这是一项针对择期耻骨后根治性前列腺切除术患者的前瞻性、双盲、安慰剂对照随机试验。在手术结束时于筋膜下放置一根小导管，并连接至弹性泵，该泵以2毫升/小时的速率向伤口内注入0.5%布比卡因或生理盐水，直至术后第3天出院。评估的结果包括患者自控镇痛系统使用的氢吗啡酮剂量、静息及活动时疼痛的视觉模拟评分（VAS）、恶心的VAS评分以及住院时间。
共有100例患者成功随机分组，所有患者均完成方案。两组在静息时VAS疼痛、活动时VAS疼痛、静脉或口服镇痛药消耗量或VAS恶心评分方面均未发现差异。
对于接受耻骨后根治性前列腺切除术患者，持续筋膜下输注局部麻醉药并未导致术后阿片类药物需求量降低或疼痛评分改善。
