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[开放性肝切除术后局部麻醉持续伤口浸润的疗效]

[Efficacy of postoperative continuous wound infiltration with local anesthesia after open hepatectomy].

作者信息

Yu Hong, Li Zhe-yong, Yu Xin

机构信息

Department of General Surgery, Sir Run Run Shao Hospital, Zhejiang University, Hangzhou 310016, China.

Department of Anesthesia, Sir Run Run Shao Hospital, Zhejiang University, Hangzhou 310016, China. Email:

出版信息

Zhonghua Yi Xue Za Zhi. 2013 Sep 10;93(34):2723-6.

Abstract

OBJECTIVE

To evaluate the efficacy of continuous wound infusion of ropivacaine for postoperative pain relief after open hepatectomy.

METHODS

From May 2011 to December 2012, 60 patients undergoing open hepatectomy were randomized into normal saline continuous infusion group (n = 30) and 0.3% ropivacaine continuous infusion group (n = 30). The following variables were recorded for the 48 hours postoperatively: pain scores at rest and sedation score every 8 hours, total sufentanil consumption, first postoperative bowel movement, length of hospitalization, nausea and vomiting score, liver function change and other adverse events were also recorded.

RESULTS

Pain scores at rest were lower for the ropivacaine group and reached significance after 8 h (all P < 0.05). The values of sufentanil consumption ((43.8 ± 21.8) vs (78.2 ± 35.2) µg, P < 0.01), time to bowel recovery ((1.2 ± 0.4) vs (1.5 ± 0.5) days, P < 0.01) and mean length of hospitalization ((6.1 ± 2.6) vs (7.6 ± 2.9) days, P < 0.05) decreased significantly. Sedation score and liver function recovery were better in ropivacaine group. No surgical wound infection occurred in either group.

CONCLUSION

Surgical wound infusion with ropivacaine is safe and effective. And it improves postoperative pain relief and accelerates patients recovery and discharge with less damage to liver function.

摘要

目的

评估罗哌卡因持续伤口灌注用于开放性肝切除术后疼痛缓解的疗效。

方法

2011年5月至2012年12月,60例行开放性肝切除术的患者被随机分为生理盐水持续灌注组(n = 30)和0.3%罗哌卡因持续灌注组(n = 30)。记录术后48小时的以下变量:每8小时的静息疼痛评分和镇静评分、舒芬太尼总消耗量、术后首次排便、住院时间、恶心呕吐评分、肝功能变化以及其他不良事件。

结果

罗哌卡因组的静息疼痛评分较低,8小时后差异有统计学意义(所有P < 0.05)。舒芬太尼消耗量的值((43.8 ± 21.8) 对 (78.2 ± 35.2) μg,P < 0.01)、肠道恢复时间((1.2 ± 0.4) 对 (1.5 ± 0.5) 天,P < 0.01)和平均住院时间((6.1 ± 2.6) 对 (7.6 ± 2.9) 天,P < 0.05)显著降低。罗哌卡因组的镇静评分和肝功能恢复情况更好。两组均未发生手术伤口感染。

结论

罗哌卡因手术伤口灌注安全有效。它能改善术后疼痛缓解,加速患者康复和出院,对肝功能的损害较小。

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