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双侧胸膜腔内注入利多卡因联合芬太尼与单纯注入利多卡因对冠状动脉搭桥术后疼痛缓解的影响。

The effect of bilateral intrapleural infusion of lidocaine with fentanyl versus only lidocaine in relieving pain after coronary artery bypasses surgery.

作者信息

Shadvar Kamran, Sanaie Sarvin, Mahmoodpoor Ata, Safarpoor Mitra, Nagipour Bahman

机构信息

Kamran Shadvar, Assistant Professor of Anesthesiology, Fellowship of Critical Care Medicine, Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

Sarvin Sanaie, Assistant Professor of Nutrition, Lung Disease and Tuberculosis Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

出版信息

Pak J Med Sci. 2017 Jan-Feb;33(1):177-181. doi: 10.12669/pjms.331.10847.

Abstract

BACKGROUND AND OBJECTIVE

Pain control during surgery in order to cause analgesia and reduce the somatic and autonomic response may decrease the morbidity. Intrapleural catheter embedding during surgery under direct vision of surgeon is safe and easy and without potential risk of thoracic epidural block. The aim of this study was to investigate the effect of bilateral intrapleural infusion of lidocaine with fentanyl versus only lidocaine in relieving pain after coronary artery bypass surgery.

METHODS

In this prospective randomized double blind clinical trial,130 adult patients undergoing elective CABG with age range of 20 to 60 years were divided into two groups receiving either lidocaine and fentanyl (group A) or lidocaine (group B). The analgesia was evaluated every two hours in all intubated and non-intubated patients using Visual analog scale (VAS) and data were analyzed using SPSS software package.

RESULTS

Of all patients, 67 (51.5%) were males and 63 (48.5%) were females. The average age of subjects was 53.49 ± 5.099 years. Mean pain score six hours after the surgery was statistically different between the groups at all times.

CONCLUSION

The pain in patients receiving combination of lidocaine and fentanyl is less than patients receiving only lidocaine.

摘要

背景与目的

手术期间的疼痛控制,旨在实现镇痛并减轻躯体和自主神经反应,这可能会降低发病率。在外科医生直视下于手术期间置入胸膜内导管既安全又简便,且无胸段硬膜外阻滞的潜在风险。本研究的目的是探讨双侧胸膜内注入利多卡因联合芬太尼与单纯注入利多卡因相比,对冠状动脉搭桥术后疼痛缓解的影响。

方法

在这项前瞻性随机双盲临床试验中,130例年龄在20至60岁之间接受择期冠状动脉搭桥术的成年患者被分为两组,分别接受利多卡因和芬太尼(A组)或利多卡因(B组)。使用视觉模拟评分法(VAS)对所有插管和未插管患者每两小时进行一次镇痛评估,并使用SPSS软件包对数据进行分析。

结果

所有患者中,67例(51.5%)为男性,63例(48.5%)为女性。受试者的平均年龄为53.49±5.099岁。术后6小时两组的平均疼痛评分在所有时间点均有统计学差异。

结论

接受利多卡因和芬太尼联合治疗的患者疼痛程度低于仅接受利多卡因治疗的患者。

相似文献

本文引用的文献

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Randomized controlled trial of bilateral intrapleural block in cardiac surgery.
Asian Cardiovasc Thorac Ann. 2011 Apr;19(2):133-8. doi: 10.1177/0218492311400921.

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