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术中静脉注射利多卡因对腹腔镜妇科腹部手术后疼痛及肠功能恢复的影响。

Effect of intraoperative intravenous lidocaine on postoperative pain and return of bowel function after laparoscopic abdominal gynecologic procedures.

作者信息

Grady Philip, Clark Nathaniel, Lenahan John, Oudekerk Christopher, Hawkins Robert, Nezat Greg, Pellegrini Joseph E

机构信息

Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.

出版信息

AANA J. 2012 Aug;80(4):282-8.

PMID:23251997
Abstract

Abdominal surgery has a high incidence of postoperative pain and dysfunctional gastrointestinal motility. This study investigated the effect of a continuous intraoperative infusion of lidocaine on patients undergoing laparoscopic gynecologic surgery. In this double-blind, placebo-controlled investigation, 50 subjects were randomly assigned to control and experimental groups. Both groups received an intravenous lidocaine bolus of 1 mg/kg on induction. The experimental group received a continuous lidocaine infusion of 2 mg/kg/h, initiated following induction and discontinued 15 to 30 minutes before skin closure. Controls received a placebo infusion. Patients in the experimental group had lower postoperative day 3 pain scores using a verbal analog scale (P = .02). Morphine equivalent dose at second request for pain treatment in the postoperative anesthesia care unit was lower in the experimental group (P = .02). There was a statistically significant difference in time interval from surgical start to return of first flatus between the groups (P = .02). Data were analyzed using descriptive and inferential statistics. A P value less than .05 was considered significant. These study results are consistent with previous research suggesting that intraoperative lidocaine infusion may improve postoperative pain levels and may shorten the time to return of bowel function.

摘要

腹部手术术后疼痛和胃肠动力功能障碍的发生率较高。本研究调查了术中持续输注利多卡因对接受腹腔镜妇科手术患者的影响。在这项双盲、安慰剂对照研究中,50名受试者被随机分为对照组和实验组。两组在诱导时均接受1mg/kg的静脉推注利多卡因。实验组在诱导后开始接受2mg/kg/h的利多卡因持续输注,并在皮肤缝合前15至30分钟停止。对照组接受安慰剂输注。实验组患者在术后第3天使用视觉模拟评分法的疼痛评分较低(P = 0.02)。实验组在术后麻醉恢复室第二次要求进行疼痛治疗时的吗啡等效剂量较低(P = 0.02)。两组之间从手术开始到首次排气的时间间隔存在统计学显著差异(P = 0.02)。使用描述性和推断性统计分析数据。P值小于0.05被认为具有显著性。这些研究结果与先前的研究一致,表明术中输注利多卡因可能改善术后疼痛水平,并可能缩短肠功能恢复时间。

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