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静脉输注利多卡因有助于中国患者腹腔镜结肠切除术后的急性康复。

Intravenous lignocaine infusion facilitates acute rehabilitation after laparoscopic colectomy in the Chinese patients.

作者信息

Lee M Wh, Or D Yl, Tsang A Cf, Ng D Ck, Chen P P, Cheung M Hy, Li R Sk, Leong H T

机构信息

Department of Orthopaedics, Queen Elizabeth Hospital, Jordan, Hong Kong.

Department of Anaesthesiology and Operating Service, North District Hospital, Sheung Shui, Hong Kong.

出版信息

Hong Kong Med J. 2017 Oct;23(5):441-5. doi: 10.12809/hkmj164984. Epub 2017 Jan 27.

Abstract

INTRODUCTION

Intravenous infusion of lignocaine has emerged in recent years as a feasible, cost-effective, and safe method to provide postoperative analgesia. There is, however, no literature about this perioperative pain control modality in Chinese patients. This study aimed to determine whether perioperative intravenous lignocaine safely reduces postoperative pain, shortens postoperative ileus, and reduces the length of hospital stay in laparoscopic colorectal surgery.

METHODS

Between September 2012 and May 2015, 16 patients who underwent elective laparoscopic resection of colorectal cancer and received a 1% lignocaine infusion for 24 hours postoperatively were studied. After surgery, categorical pain scores were obtained immediately, followed by hourly pain scores at rest. Pain scores at rest and with mobilisation, and patient satisfaction score were documented on postoperative day 1. Return of bowel function was measured by time of first flatus and bowel opening. The patient's rehabilitation was assessed by time taken to tolerate diet, full mobilisation, and length of hospital stay.

RESULTS

The median (interquartile range) self-reported pain scores at 2 hours and 6 hours after surgery were 1.5 (0-4) and 2 (0-3), respectively. The median pain scores at rest and mobilisation on postoperative day 1 were 1 (0-2.5) and 2 (2.5-5), respectively, with a median satisfaction score of 7.5 (7-9). The median times to first flatus and first bowel opening were 21 (18-35) hours and 3 (1-3) days, respectively. No patient had postoperative ileus. The median times to tolerating diet and mobilisation were 1 (1-1) day and 2 (2-3) days, respectively. The median postoperative stay was 6 (5-8) days.

CONCLUSIONS

Intravenous lignocaine is a safe and effective postoperative analgesic in a Chinese population. It enhances the rehabilitation process for patients following laparoscopic resection of colorectal cancer.

摘要

引言

近年来,静脉输注利多卡因已成为一种可行、经济高效且安全的术后镇痛方法。然而,关于中国患者围手术期疼痛控制方式的相关文献尚不存在。本研究旨在确定围手术期静脉输注利多卡因是否能安全减轻术后疼痛、缩短术后肠梗阻时间并减少腹腔镜结直肠癌手术患者的住院时间。

方法

在2012年9月至2015年5月期间,对16例行择期腹腔镜结直肠癌切除术且术后接受24小时1%利多卡因输注的患者进行研究。术后立即获取分类疼痛评分,随后记录静息时的每小时疼痛评分。术后第1天记录静息及活动时的疼痛评分以及患者满意度评分。通过首次排气和排便时间来衡量肠功能恢复情况。通过耐受饮食、完全活动所需时间及住院时间来评估患者的康复情况。

结果

术后2小时和6小时自我报告的疼痛评分中位数(四分位间距)分别为1.5(0 - 4)和2(0 - 3)。术后第1天静息和活动时的疼痛评分中位数分别为1(0 - 2.5)和2(2.5 - 5),满意度评分中位数为7.5(7 - 9)。首次排气和首次排便的中位数时间分别为21(18 - 35)小时和3(1 - 3)天。无患者发生术后肠梗阻。耐受饮食和活动的中位数时间分别为1(1 - 1)天和2(2 - 3)天。术后住院时间中位数为6(5 - 8)天。

结论

静脉输注利多卡因在中国人群中是一种安全有效的术后镇痛药。它可促进腹腔镜结直肠癌切除术后患者的康复进程。

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