Beqiri Arben I, Domi Rudin Q, Sula Hektor H, Zaimi Edmond Q, Petrela Elizana Y
Department of General Surgery, University Hospital Center Mother Teresa, Tirana, Albania.
Saudi Med J. 2012 Feb;33(2):134-8.
To evaluate the efficacy of combined infiltrative bupivacaine with low intraperitoneal pressure insufflation in reducing the post-laparoscopic pain in patients undergoing laparoscopic cholecystectomy (LC).
This randomized prospective single-blind study included 473 patients undergoing LC. The study took place at University Hospital Center Mother Teresa, Tirana, Albania between January 2006 to September 2009. The patients were divided in 4 groups: Group 1 (n=120) with intra-abdominal insufflation pressure 15 mm Hg and no infiltrative bupivacaine (HPNBG); Group 2 (n=122) with intra-abdominal insufflation pressure 15 mm Hg and with 5 ml infiltrative bupivacaine 0.5% in abdominal minincisions (HPBG); Group 3 (n=110) with intra-abdominal insufflation pressure under 10 mm Hg and no infiltrative bupivacaine (LPNBG); and Group 4 (n=121) with intra-abdominal insufflation pressure under 10 mm Hg and infiltrative bupivacaine (LPBG).
There were statistically significant differences (p=0.003) between groups regarding incisional pain intensity, between LPBG and HPNBG (p=0.001), between LPBG and HPBG (p=0.037), between LPBG and LPNBG (p=0.001), as well the shoulder-tip pain intensity (p=0.001); between LPBG and HPNBG (p=0.001), between LPBG and HPBG (p=0.001), and between LPBG and LPNBG (p=0.031). We found statistically significant differences related to pain beginning time (ANOVA test, p=0.027); between LPBG and HPNBG (p=0.041), between LPBG and HPBG (p=0.031), and between LPBG and LPNBG (p=0.05).
The combination of infiltrative bupivacaine with low intraperitoneal pressure insufflation shows to be more efficient in reducing the post-laparoscopic pain, compared with other regimens.
评估布比卡因浸润联合低腹腔内压力气腹在减轻腹腔镜胆囊切除术（LC）患者术后疼痛方面的疗效。
这项随机前瞻性单盲研究纳入了473例行LC的患者。研究于2006年1月至2009年9月在阿尔巴尼亚地拉那的特蕾莎修女大学医院中心进行。患者被分为4组：第1组（n = 120），腹腔内充气压力15 mmHg，未使用布比卡因浸润（HPNBG）；第2组（n = 122），腹腔内充气压力15 mmHg，在腹部小切口处使用5 ml 0.5%布比卡因浸润（HPBG）；第3组（n = 110），腹腔内充气压力低于10 mmHg，未使用布比卡因浸润（LPNBG）；第4组（n = 121），腹腔内充气压力低于10 mmHg，使用布比卡因浸润（LPBG）。
各组之间在切口疼痛强度方面存在统计学显著差异（p = 0.003），LPBG与HPNBG之间（p = 0.001），LPBG与HPBG之间（p = 0.037），LPBG与LPNBG之间（p = 0.001），以及肩峰疼痛强度方面（p = 0.001）；LPBG与HPNBG之间（p = 0.001），LPBG与HPBG之间（p = 0.001），以及LPBG与LPNBG之间（p = 0.031）。我们发现与疼痛开始时间相关存在统计学显著差异（方差分析，p = 0.027）；LPBG与HPNBG之间（p = 0.041），LPBG与HPBG之间（p = 0.031），以及LPBG与LPNBG之间（p = 0.05）。
与其他方案相比，布比卡因浸润联合低腹腔内压力气腹在减轻腹腔镜术后疼痛方面显示出更高的效率。
