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腹腔镜结直肠癌手术中腹腔内注射右美托咪定联合布比卡因的疗效及安全性:一项随机试验

Efficacy and safety of intraperitoneal dexmedetomidine with bupivacaine in laparoscopic colorectal cancer surgery, a randomized trial.

作者信息

Fares Khaled Mohamed, Mohamed Sahar Abd-Elbaky, Abd El-Rahman Ahmad Mohammad, Mohamed Ashraf Amin, Amin Anwar Tawfik

机构信息

Department of Anesthesia, Intensive Care, and Pain Management, South Egypt Cancer Institute, Assiut, Egypt.

Department of Surgical Oncology, South Egypt Cancer Institute, Assiut University, Assiut, Egypt.

出版信息

Pain Med. 2015 Jun;16(6):1186-94. doi: 10.1111/pme.12687. Epub 2015 Jan 13.

Abstract

OBJECTIVE

Our objective is to investigate the efficacy and safety of intraperitoneal dexmedetomidine (Dex) combined with bupivacaine in patients undergoing laparoscopic colorectal cancer surgery.

DESIGN

Randomized double-blind study.

SETTING

Academic medical center.

PATIENTS AND METHODS

Forty-five patients scheduled for laparoscopic colorectal cancer surgery were randomly assigned for intraperitoneal administration of 50 mL saline (control group; GI, n = 15), 50 mL bupivacaine 0.25% (125 mg; GII, n = 15), or 50 mL bupivacaine 0.25% (125 mg) +1 μg/kg Dex (GIII, n = 15). Patients were assessed during the first 24 hours postoperatively for hemodynamics, visual analogue scale (VAS), time to first request of analgesia, total analgesic consumption, shoulder pain, and side effects.

RESULTS

A significant reduction was observed in VAS in GIII at base line, 2, 4, and 24 hours postoperatively in comparison to GI and GII (P < 0.05). The time to first analgesic requirement was significantly prolonged in GIII (P < 0.05). The mean total consumption of rescue analgesia was significantly reduced in GIII.

CONCLUSION

We conclude that intraperitoneal administration of Dex 1 μg/kg combined with bupivacaine improves the quality and the duration of postoperative analgesia and provides an analgesic sparing effect compared to bupivacaine alone without significant adverse effects in patients undergoing laparoscopic colorectal cancer surgery.

摘要

目的

我们的目的是研究腹腔镜结直肠癌手术患者腹腔内注射右美托咪定(Dex)联合布比卡因的有效性和安全性。

设计

随机双盲研究。

地点

学术医疗中心。

患者与方法

45例计划行腹腔镜结直肠癌手术的患者被随机分为腹腔内注射50 mL生理盐水(对照组;GI组,n = 15)、50 mL 0.25%布比卡因(125 mg;GII组,n = 15)或50 mL 0.25%布比卡因(125 mg)+1 μg/kg Dex(GIII组,n = 15)。术后24小时内对患者的血流动力学、视觉模拟评分(VAS)、首次要求镇痛的时间、总镇痛药物消耗量、肩部疼痛及副作用进行评估。

结果

与GI组和GII组相比,GIII组在基线、术后2、4和24小时的VAS显著降低(P < 0.05)。GIII组首次镇痛需求时间显著延长(P < 0.05)。GIII组急救镇痛的平均总消耗量显著降低。

结论

我们得出结论,对于接受腹腔镜结直肠癌手术的患者,腹腔内注射1 μg/kg Dex联合布比卡因可改善术后镇痛质量和持续时间,与单独使用布比卡因相比具有镇痛节省效应,且无明显不良反应。

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