Lee Ko-Chao, Lu Chien-Chang, Lin Shung-Eing, Chang Chia-Lo, Chen Hong-Hwa
Hepatogastroenterology. 2015 Jun;62(140):811-6.
BACKGROUND/AIMS: Minimally invasive laparoscopy provides faster recovery, less pain, fewer complications, and better cosmesis than laparotomy. We aimed to evaluate outcomes of postoperative local anesthesia infiltration at the single-incision laparoscopic surgery (SILS) wound.
This prospective, non-randomized controlled study evaluated outcomes of 58 colorectal cancer cases receiving SILS from May 2010 to December 2010. Twenty-nine patients received postoperative infiltration of local anesthesia at the wound site; another 29 patients did not. Demographic, intra- and postoperative data were compared. Postoperative pain was assessed by visual analogue scale and analgesic usage.
Local anesthesia group included 16 males, 13 females (mean age, 62.0 ± 15.1 years); no local anesthesia group included 14 males, 15 females (mean age, 58.1 ± 12.7 years). There were no significant differences between groups at baseline (i.e., age, gender, disease stage, tumor location or size) except BMI (25.2 ± 2.8 vs. 23.5 ± 3.4, p = 0.041) was significantly higher. Postoperative pain scores were significantly lower in local anesthesia group than in no local anesthesia group (median VAS score 2.0, IQR 2.0-3.0 vs. VAS score 3.0, IQR 3.0-4.0, respectively, P = 0.024).
Our results provide further evidence of SILS safety. Local anesthesia infiltration at SILS wounds decreases postoperative wound pain and analgesic usage.
背景/目的：与开腹手术相比，微创腹腔镜手术恢复更快、疼痛更少、并发症更少且美容效果更好。我们旨在评估单孔腹腔镜手术（SILS）伤口术后局部麻醉浸润的效果。
这项前瞻性、非随机对照研究评估了2010年5月至2010年12月接受SILS的58例结直肠癌病例的效果。29例患者在伤口部位接受了术后局部麻醉浸润；另外29例患者未接受。比较了人口统计学、术中和术后数据。通过视觉模拟量表和镇痛药物使用情况评估术后疼痛。
局部麻醉组包括16例男性、13例女性（平均年龄62.0±15.1岁）；未进行局部麻醉组包括14例男性、15例女性（平均年龄58.1±12.7岁）。除BMI（25.2±2.8 vs. 23.5±3.4，p = 0.041）显著较高外，两组在基线时（即年龄、性别、疾病分期、肿瘤位置或大小）无显著差异。局部麻醉组的术后疼痛评分显著低于未进行局部麻醉组（中位VAS评分分别为2.0，IQR 2.0 - 3.0 vs. VAS评分3.0，IQR 3.0 - 4.0，P = 0.024）。
我们的结果进一步证明了SILS的安全性。SILS伤口局部麻醉浸润可减轻术后伤口疼痛和镇痛药物使用。
