Abet Emeric, Orion François, Denimal Fabrice, Brau-Weber Anne-Géraldine, de Kerviler Benoît, Jean Marc-Henri, Boulanger Guillaume, Dimet Jérôme, Comy Michel
Digestive Surgery Service, Vendée Hospital Center, Les Oudairies, 85000, La Roche Sur Yon, France.
Anesthesiology Service, Vendée Hospital Center, 85000, La Roche Sur Yon, France.
World J Surg. 2017 Mar;41(3):687-692. doi: 10.1007/s00268-016-3797-2.
The objective of this study was to evaluate the interest of using ropivacaine for outpatient laparoscopic cholecystectomy. The use of local anesthesia by instillation and infiltration could reduce pain and increase the number of outpatient cholecystectomies.
A one-center randomized prospective clinical trial compared the use of ropivacaine during outpatient laparoscopic cholecystectomy to the control group of outpatients for laparoscopic cholecystectomy between April 2014 and May 2015. One hundred twenty-four were eligible, and 100 patients were randomized. Patients with outpatient cholecystectomy were randomized into 2 groups: ropivacaine group (Rop group) and control group (control group). We performed a ropivacaine intraperitoneal instillation and wound infiltration for the ropivacaine group at the end of the procedure. The primary observation was authorization for home discharge. The patient was evaluated by the surgeon using the Chung score. Secondary observations included postoperative pain at 2 h post-surgery, at 6 h post-surgery and the day following surgery.
Ninety-eight were able to leave on the evening of surgery. At 6 h post-surgery, the Chung score was identical for both groups (p = 0.73). At 2 and 6 h post-surgery and the day following surgery, there was no significant difference in pain levels (p = 0.63; p = 0.61; p = 0.98). Analgesic consumption was no significant difference in the groups.
The use of ropivacaine does not increase the rate of home discharge and does not change the postoperative pain of outpatient cholecystectomy.
本研究的目的是评估使用罗哌卡因进行门诊腹腔镜胆囊切除术的可行性。通过滴注和浸润使用局部麻醉可以减轻疼痛并增加门诊胆囊切除术的数量。
一项单中心随机前瞻性临床试验比较了2014年4月至2015年5月期间门诊腹腔镜胆囊切除术中使用罗哌卡因与门诊腹腔镜胆囊切除术对照组的情况。124例符合条件，100例患者被随机分组。门诊胆囊切除术患者被随机分为2组：罗哌卡因组（Rop组）和对照组。在手术结束时，我们对罗哌卡因组进行了罗哌卡因腹腔内滴注和伤口浸润。主要观察指标是出院许可。外科医生使用Chung评分对患者进行评估。次要观察指标包括术后2小时、术后6小时和术后次日的疼痛情况。
98例患者能够在手术当晚出院。术后6小时，两组的Chung评分相同（p = 0.73）。术后2小时、6小时和术后次日，疼痛程度无显著差异（p = 0.63；p = 0.61；p = 0.98）。两组间镇痛药消耗量无显著差异。
使用罗哌卡因不会提高出院率，也不会改变门诊胆囊切除术的术后疼痛情况。
