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[局部应用罗哌卡因与标准镇痛用于腹腔镜胆囊切除术的比较]

[Locally administered ropivacaine vs. standard analgesia for laparoscopic cholecystectomy].

作者信息

Chavarría-Pérez Teresa, Cabrera-Leal Carlos Fernando, Ramírez-Vargas Susana, Reynada José Luis, Arce-Salinas César Alejandro

机构信息

Servicio de Anestesiología, Hospital Central Sur de Alta Especialidad de Petróleos Mexicanos, Distrito Federal, México.

出版信息

Rev Med Inst Mex Seguro Soc. 2015 May-Jun;53(3):274-8.

PMID:25984611
Abstract

BACKGROUND

It is unknown which analgesic modality gives better results after a laparoscopic cholecystectomy. The aim of this study was to compare the analgesic efficacy of ropivacaine for local use against that of intravenous dipyrone in laparoscopic cholecystectomy.

METHODS

A non-inferiority randomized clinical trial. Fifty patients with laparoscopic cholecystectomy were included into two separate groups.

INTERVENTION

0.75 % ropivacaine infiltrated at the trocar insertion sites and in the gallbladder fossa compared with intravenous dipyrone.

MEASUREMENTS

The primary outcome was pain, which was assessed using the visual analog scale during the first 24 hours. Secondary outcomes were the presence of adverse effects, and the need for analgesic rescue with tramadol.

RESULTS

The visual analog scale average for pain at the conclusion of the surgery was 3.8 in the ropivacaine vs. 3.56 in the dipyrone groups, while at 6, 12 and 24 hours the values were 2.64, 1.92 and 1.28, respectively, for ropivacaine versus 2.6, 1.88 and 1.2, respectively, for dipyrone. No adverse effects were observed in either group, and the two groups exhibited similar needs for analgesic rescue with tramadol.

CONCLUSIONS

Infiltration of 0.75 % ropivacaine at the trocar insertion sites and the gallbladder exhibits analgesia similar to IV dipyrone during the first 24 hours post-laparoscopic cholecystectomy without adverse effects.

摘要

背景

腹腔镜胆囊切除术后哪种镇痛方式效果更佳尚不清楚。本研究旨在比较局部使用罗哌卡因与静脉注射安乃近在腹腔镜胆囊切除术中的镇痛效果。

方法

一项非劣效性随机临床试验。50例行腹腔镜胆囊切除术的患者被纳入两个独立的组。

干预措施

与静脉注射安乃近相比,在套管针穿刺部位和胆囊窝注入0.75%罗哌卡因。

测量指标

主要结局为疼痛,在术后24小时内使用视觉模拟评分法进行评估。次要结局为不良反应的发生情况以及使用曲马多进行镇痛补救的需求。

结果

手术结束时,罗哌卡因组疼痛的视觉模拟评分平均值为3.8,安乃近组为3.56;而在术后6小时、12小时和24小时,罗哌卡因组的值分别为2.64、1.92和1.28,安乃近组分别为2.6、1.88和1.2。两组均未观察到不良反应,且两组使用曲马多进行镇痛补救的需求相似。

结论

在腹腔镜胆囊切除术后的头24小时内,在套管针穿刺部位和胆囊注入0.75%罗哌卡因的镇痛效果与静脉注射安乃近相似,且无不良反应。

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Medicine (Baltimore). 2020 Nov 13;99(46):e22540. doi: 10.1097/MD.0000000000022540.