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预防性罗哌卡因在腹股沟疝修补术中的影响——一项随机对照试验。

The impact of preemptive ropivacaine in inguinal hernioplasty--a randomized controlled trial.

机构信息

Department of Surgery, Ghurki Trust Teaching Hospital, Jallo Mor, Lahore, Pakistan.

Department of Surgery, Ghurki Trust Teaching Hospital, Jallo Mor, Lahore, Pakistan.

出版信息

Int J Surg. 2015 Jan;13:76-79. doi: 10.1016/j.ijsu.2014.11.037. Epub 2014 Dec 3.

Abstract

INTRODUCTION

This study was aimed to assess the outcome of Ilioinguinal, Iliohypogastric block and wound infiltration with 0.75% ropivacaine on pain perception, first analgesic request and hospital stay following inguinal Lichtenstein mesh repair.

METHOD

This was a prospective, randomized, double-blind study with 60 patients undergoing inguinal hernioplasty under general anesthesia. Patients were randomly allocated to one of the two groups by the sealed envelope method. Group 1 (n=30) received nerve blocks and incision infiltration with 0.75% ropivacaine while group 2 (n=30) received isotonic saline. Postoperatively pain intensity, time of demand for the first analgesic and duration of hospital stay were assessed.

RESULTS

Median Visual Analog Scale (VAS) score of group 1 was 4 (high=6, low=3) while for group 2 was 5.50 (high=8, low=4) and the p value was <0.001. Mean time for the demand of the first analgesic was prolonged from 1.19±1.05 h to 5.31±1.14 h with the p value of <0.0005, while the mean time of hospital stay was reduced from 22.5±3.30 h to 14.1±2.99 h with the p value of <0.0005.

CONCLUSION

Preemptive analgesia with 0.75% ropivacaine causes significant reduction in pain perception, request for an analgesic and hospital stay. Therefore it is advisable before inguinal hernioplasty.

摘要

引言

本研究旨在评估 0.75%罗哌卡因用于髂腹股沟、髂腹下神经阻滞和切口浸润对腹股沟 Lichtenstein 网片修补术后疼痛感知、首次镇痛需求和住院时间的影响。

方法

这是一项前瞻性、随机、双盲研究,共纳入 60 例全身麻醉下行腹股沟疝修补术的患者。患者通过密封信封法随机分为两组。第 1 组(n=30)接受 0.75%罗哌卡因的神经阻滞和切口浸润,第 2 组(n=30)接受等渗盐水。术后评估疼痛强度、首次镇痛需求时间和住院时间。

结果

第 1 组的中位数视觉模拟评分(VAS)为 4(高=6,低=3),第 2 组为 5.50(高=8,低=4),p 值<0.001。第 1 组首次镇痛需求时间从 1.19±1.05 小时延长至 5.31±1.14 小时,p 值<0.0005,第 1 组住院时间从 22.5±3.30 小时缩短至 14.1±2.99 小时,p 值<0.0005。

结论

0.75%罗哌卡因的预防性镇痛可显著降低疼痛感知、镇痛需求和住院时间。因此,在腹股沟疝修补术前使用是明智的。

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