Yang So Young, Kang Hyun, Choi Geun Joo, Shin Hwa Yong, Baek Chong Wha, Jung Yong Hun, Choi Yoo Shin
Department of Anaesthesiology and Pain Medicine, College of Medicine, Chung-Ang University, Seoul, Republic of Korea.
J Int Med Res. 2014 Apr;42(2):307-19. doi: 10.1177/0300060513505493.
This randomized, double-blind, placebo-controlled trial evaluated intraperitoneal (IP) lidocaine administration and intravenous (IV) lidocaine infusion for postoperative pain control after laparoscopic cholecystectomy (LC).
Patients who underwent LC were randomized to either group IV (intravenous lidocaine infusion), group IP (intraperitoneal lidocaine administration), or group C (control, IP and IV saline). Outcome measures were total postoperative pain severity (TPPS), total fentanyl consumption (TFC), frequency of administering patient-controlled analgesia (FPB), and a pain control satisfaction score (PCSS).
Significantly reduced TPPS, TFC and FPB scores were observed in groups IP (n = 22) and IV (n = 26) compared with controls (n = 24). PCSS was higher in groups IP and IV than in controls. At 2 h postoperation, TPPS was significantly lower in group IP than group IV; at 0-2 h postoperation, FPB was lower in group IP than group IV.
The IP administration of lidocaine and IV lidocaine infusion significantly reduced postoperative pain and opioid consumption in LC patients, compared with control infusions. For convenience, IV lidocaine could be used for pain reduction following LC; IP administration places additional burden on the surgeon.
本随机、双盲、安慰剂对照试验评估了腹腔镜胆囊切除术（LC）后腹腔内（IP）注射利多卡因和静脉（IV）输注利多卡因对术后疼痛的控制效果。
接受LC的患者被随机分为IV组（静脉输注利多卡因）、IP组（腹腔内注射利多卡因）或C组（对照组，腹腔内和静脉内注射生理盐水）。观察指标包括术后疼痛总严重程度（TPPS）、芬太尼总消耗量（TFC）、患者自控镇痛给药频率（FPB）和疼痛控制满意度评分（PCSS）。
与对照组（n = 24）相比，IP组（n = 22）和IV组（n = 26）的TPPS、TFC和FPB评分显著降低。IP组和IV组的PCSS高于对照组。术后2小时，IP组的TPPS显著低于IV组；术后0 - 2小时，IP组的FPB低于IV组。
与对照输注相比，腹腔内注射利多卡因和静脉输注利多卡因显著减轻了LC患者的术后疼痛并减少了阿片类药物的消耗。为方便起见，静脉输注利多卡因可用于LC术后的疼痛减轻；腹腔内注射给外科医生增加了额外负担。
