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罗哌卡因与罗哌卡因联合地塞米松切口浸润在择期腹腔镜胆囊切除术中的镇痛效果

[Analgesic efficacy of the incisional infiltration of ropivacaine vs ropivacaine with dexamethasone in the elective laparoscopic cholecystectomy].

作者信息

Evaristo-Méndez Gerardo, García de Alba-García Javier Eduardo, Sahagún-Flores José Ernesto, Ventura-Sauceda Félix Antonio, Méndez-Ibarra Jorge Uriel, Sepúlveda-Castro Rogelio Ricardo

机构信息

Departamento de Cirugía General, Hospital Regional Dr. Valentín Gómez Farías, ISSSTE. Zapopan, Jalisco, México.

Unidad de Investigación Social, Epidemiológica y en Servicios de Salud, IMSS-Jalisco, México.

出版信息

Cir Cir. 2013 Sep-Oct;81(5):383-93.

Abstract

BACKGROUND

Incisional pain is the main obstacle for elective laparoscopic cholecystectomy as an outpatient. We evaluated the analgesic efficacy of local infiltration of ropivacaine with dexamethasone (Rop/Dx), compared with ropivacaine (Rop) alone, during the first 24 hours postoperative of this surgery. Our hypothesis is that incisional pain intensity will be lower in patients of the group Rop/Dx.

METHODS

In a randomized, controlled, double-blind trial clinical, 80 patients were divided into two groups. Group Rop (n= 40) received pre and post-incisional infiltration with 150 mg of ropivacaine in 8 mL of 0.9% saline, while group Rop/Dx (n= 40) received 150 mg of ropivacaine with 8 mg of dexamethasone in 6 mL of 0.9% saline. The intensity of pain at rest and movement was assessed at 2, 4, 8, 12 and 24 hours postoperatively by a numerical rating scale of 11 points.

RESULTS

Incisional pain scores in group Rop/Dx were significantly lower, compared to the group Rop, at 12 hours (p= 0.05) and 24 hours (p= 0.01) at rest and at 12 hours (p= 0.04) and 24 hours (p= 0.01) during movement postoperatively.

CONCLUSIONS

We found initial evidence that ropivacaine with dexamethasone for local infiltration decreased incisional pain intensity after 12 hours post-elective laparoscopic cholecystectomy with a good safety profile.

摘要

背景

切口疼痛是择期腹腔镜胆囊切除术作为门诊手术的主要障碍。我们评估了罗哌卡因与地塞米松局部浸润(Rop/Dx)与单独使用罗哌卡因(Rop)相比,在该手术术后24小时内的镇痛效果。我们的假设是Rop/Dx组患者的切口疼痛强度会更低。

方法

在一项随机、对照、双盲临床试验中,80例患者被分为两组。Rop组(n = 40)在切口前后分别用8 mL 0.9%盐水中的150 mg罗哌卡因进行浸润,而Rop/Dx组(n = 40)在6 mL 0.9%盐水中接受150 mg罗哌卡因与8 mg地塞米松。术后2、4、8、12和24小时通过11分数字评分量表评估静息和活动时的疼痛强度。

结果

术后12小时(p = 0.05)和24小时(p = 0.01)静息时以及术后12小时(p = 0.04)和24小时(p = 0.01)活动时,Rop/Dx组的切口疼痛评分明显低于Rop组。

结论

我们发现初步证据表明,罗哌卡因与地塞米松局部浸润在择期腹腔镜胆囊切除术后12小时后可降低切口疼痛强度,且安全性良好。

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