Department of Surgery, The First Affiliated Hospital of JinZhou Medical University, People's Republic of China.
Department of Surgery, The First Affiliated Hospital of JinZhou Medical University, People's Republic of China.
Int J Surg. 2017 Aug;44:229-243. doi: 10.1016/j.ijsu.2017.06.043. Epub 2017 Jun 30.
Pain is one of the important reasons for delayed discharge and Enhanced Recovery After Surgery (ERAS) after laparoscopic cholecystectomy. To assess the benefits and disadvantage of intraperitoneal instillation of ropivacaine in people undergoing laparoscopic cholecystectomy.
We searched the MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and Science Citation Index Expanded to December 2016 to identify randomised clinical trials of relevance to this review. We analysed the data with Review Manager 5 analysis.
We identified 12 suitable studies. A total of 853 participants were randomised to intraperitoneal ropivacaine instillation (442 participants) versus "no intraperitoneal ropivacaine instillation" (411 participants). The pain scores as measured by the visual analogue scale (VAS) were significantly lower in the ropivacaine instillation group than the control group at 4-8 h (10 trials; 751 participants; MD -0.64 cm; 95% CI -0.86 to -0.43; p < 0.00001) and at 9-24 h (9 trials; 582 participants; MD -0.47 cm; 95% CI -0.66 to -0.28; p < 0.00001).The proportion of people who developed the adverse events were less in the ropivacaine instillation group than the control group(RR 0.60; 95% CI 0.45 to 0.79; p = 0.0002). There was no significant difference in the Post-anesthesia care unit (PACU) stay time between the two groups (3 trials; 197 participants; MD -3.77 min; 95% CI -10.24 to 2.69). The overall quality of evidence was very low. Further trials are necessary.
疼痛是腹腔镜胆囊切除术后延迟出院和增强术后恢复（ERAS）的重要原因之一。评估在腹腔镜胆囊切除术中腹腔内灌注罗哌卡因的益处和弊端。
我们检索了 MEDLINE、EMBASE、Cochrane 对照试验中心注册库（CENTRAL）和科学引文索引扩展版到 2016 年 12 月，以确定与本综述相关的随机临床试验。我们使用 Review Manager 5 分析数据。
我们确定了 12 项合适的研究。共有 853 名参与者被随机分配到腹腔内罗哌卡因灌注组（442 名参与者）与“无腹腔内罗哌卡因灌注”组（411 名参与者）。罗哌卡因灌注组的视觉模拟评分（VAS）疼痛评分在 4-8 小时（10 项试验；751 名参与者；MD -0.64cm；95%CI -0.86 至 -0.43；p < 0.00001）和 9-24 小时（9 项试验；582 名参与者；MD -0.47cm；95%CI -0.66 至 -0.28；p < 0.00001）时显著低于对照组。罗哌卡因灌注组发生不良反应的比例低于对照组（RR 0.60；95%CI 0.45 至 0.79；p = 0.0002）。两组患者在麻醉后护理病房（PACU）停留时间方面无显著差异（3 项试验；197 名参与者；MD -3.77 分钟；95%CI -10.24 至 2.69）。总体证据质量非常低。需要进一步的试验。
