Saxena S K, Lahiri G K
Graded Specialist (Anaesthesiology), Military Hospital, Bhuj-Kachchh, Gujarat 370 001.
Classified Specialist (Surgery), Military Hospital, Bhuj-Kachchh, Gujarat 370 001.
Med J Armed Forces India. 2000 Oct;56(4):309-313. doi: 10.1016/S0377-1237(17)30216-2. Epub 2017 Jun 12.
A simple, safe, and effective technique of postop analgesia using wound perfusion with bupivacaine 0.25% via an indwelling intracatheter inserted in the depth of the wound was carried out on 25 ASA grade I/II patients of varying age groups reporting for a variety of surgical procedures. The first dose was given prior to shifting the patient from the OT. Subsequent doses were administered on patient demand basis. The intracatheter was kept in position for 48-72 hours postop. An analysis was made on the patients' pain relief using a visual analogue scale, dose/frequency of bupivacaine required, dose/type of supplemental analgesia needed, haemodynamic changes during infiltration, wound healing, and patient satisfaction. In this study only 12% of patients required opioids on Day One postoperatively. There were no adverse effects of infiltration either systemically or on wound healing, and all the patients had excellent postop analgesia.
对25例因各种外科手术前来就诊、年龄各异的美国麻醉医师协会(ASA)I/II级患者,实施了一项简单、安全且有效的术后镇痛技术,即通过插入伤口深处的留置导管灌注0.25%布比卡因进行伤口局部浸润。首剂在患者从手术室转移前给予。后续剂量根据患者需求给药。术后,留置导管保留48 - 72小时。使用视觉模拟评分法对患者的疼痛缓解情况、所需布比卡因的剂量/频率、所需补充镇痛剂的剂量/类型、浸润期间的血流动力学变化、伤口愈合情况以及患者满意度进行了分析。在本研究中,仅12%的患者在术后第一天需要使用阿片类药物。局部浸润无论是对全身还是伤口愈合均无不良影响,所有患者术后镇痛效果良好。