Department of Obstetrics and Gynaecology, University of Western Ontario, London, Ontario, Canada.
J Minim Invasive Gynecol. 2012 Sep-Oct;19(5):545-53. doi: 10.1016/j.jmig.2012.04.002. Epub 2012 Jul 3.
We reviewed the effectiveness of intraperitoneal instillation of local anesthetic on pain after gynecologic laparoscopic surgery. Sources included the Cochrane Central Register of Controlled Trials, MEDLINE/PubMed, EMBASE, and Ovid MEDLINE In-Process & Other Non-Indexed Citations databases, and abstracts, reference lists, and randomized controlled trial (RCT) registries. The 7 included RCTs compared pain scores after administration of intraperitoneal analgesics or placebo/control during gynecologic laparoscopic surgery with benign indications. Outcome measures were pain scores (per visual analog scale) at 1 to 2, 4 to 6, and 24 hours postoperatively. Pain scores were significantly lower in the groups receiving local anesthesia at 1 to 2 hours (weighted mean difference [WMD], -1.82; 95% confidence interval [CI], -2.55 to -1.08]) and 4 to 6 hours postoperatively (WMD, -2.00; 95% CI, -3.64 to -0.35), but were similar at 24 hours (WMD, -1.43; 95% CI, -1.15 to 0.96). Local analgesia instilled intraperitoneally significantly decreased pain during a 6-hour interval after gynecologic laparoscopy.
我们回顾了腹腔内局部麻醉在妇科腹腔镜手术后疼痛中的有效性。资料来源包括 Cochrane 对照试验中心注册库、MEDLINE/PubMed、EMBASE 和 Ovid MEDLINE 在处理和其他非索引引文数据库，以及摘要、参考文献列表和随机对照试验 (RCT) 登记处。7 项纳入的 RCT 比较了良性指征下妇科腹腔镜手术中给予腹腔内镇痛药或安慰剂/对照后 1 至 2、4 至 6 和 24 小时的疼痛评分。在 1 至 2 小时（加权均数差 [WMD]，-1.82；95%置信区间 [CI]，-2.55 至 -1.08]）和术后 4 至 6 小时（WMD，-2.00；95% CI，-3.64 至 -0.35）时，接受局部麻醉的组的疼痛评分显著降低，但在 24 小时时相似（WMD，-1.43；95% CI，-1.15 至 0.96）。腹腔内注入局部镇痛在妇科腹腔镜手术后 6 小时内显著减轻疼痛。
