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单切口腹腔镜结肠切除术后伤口部位局部麻醉浸润可减轻术后疼痛并减少镇痛药物使用。

Infiltration of Local Anesthesia at Wound Site after Single-Incision Laparoscopic Colectomy Reduces Postoperative Pain and Analgesic Usage.

作者信息

Lee Ko-Chao, Lu Chien-Chang, Lin Shung-Eing, Chang Chia-Lo, Chen Hong-Hwa

出版信息

Hepatogastroenterology. 2015 Jun;62(140):811-6.

Abstract

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.

METHODOLOGY

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.

RESULTS

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).

CONCLUSIONS

Our results provide further evidence of SILS safety. Local anesthesia infiltration at SILS wounds decreases postoperative wound pain and analgesic usage.

摘要

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。

方法

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。

结果

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)。

结论

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。

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