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比较腹腔灌洗利多卡因、布比卡因和生理盐水对减少大鼠腹部粘连带形成的作用

Comparing Lavage of the Peritoneal Cavity with Lidocaine, Bupivacaine and Normal Saline to Reduce the Formation of Abdominal Adhesion Bands in Rats.

作者信息

Parsa Hossein, Saravani Hengameh, Sameei-Rad Fatemeh, Nasiri Marjan, Farahaninik Zahra, Rahmani Amirhossein

机构信息

Department of Surgery, Velayat Clinical Research Development Unit, Qazvin University of Medical Sciences, Shahid Bahonar Blvd, 3419759811 Qazvin, Iran.

Metabolic Diseases Research Center, Qazvin University of Medical Sciences, Shahid Bahonar Blvd, 3419759811 Qazvin, Iran.

出版信息

Malays J Med Sci. 2017 May;24(3):26-32. doi: 10.21315/mjms2017.24.3.4. Epub 2017 Jun 30.

Abstract

BACKGROUND

Intra-abdominal adhesions are fibrous bands that develop after abdominal surgery or inflammation and cause mortality and morbidity following surgeries. This study aimed to assess the effects of bupivacaine, saline and two doses of lidocaine, after peritoneal lavage and to compare their effects in reducing abdominal adhesions in rat.

METHODS

In a blinded, randomised, placebo-controlled clinical trial, 50 female rats were anaesthetised and the parietal peritoneum was scratched to induce punctate bleeding. The rats were randomly assigned to five groups: saline, lidocaine 2% (3 and 6 mg/kg), bupivacaine 0.25% (2 mg/kg) and control (no irrigation). The peritoneal cavity was irrigated with the appropriate solution during laparotomy. Two weeks later, re-laparotomy was performed. The quantity, quality, severity and scores of adhesions were recorded and compared.

RESULTS

The quantity and quality of adhesions were significantly higher in the control group than in the lidocaine (6 mg/kg) and bupivacaine groups. The quality of the adhesions was higher in the normal saline group than in the lidocaine (6 mg/kg) and bupivacaine groups. The severity of adhesions between the lidocaine 3 and 6 mg/kg groups and between the lidocaine 3 mg/kg and saline groups was lower than that in the control group.

CONCLUSION

Using lidocaine (6 mg/kg) and bupivacaine lavage in first laparotomy reduces abdominal peritoneal obstruction because of the formation of adhesion bands.

摘要

背景

腹腔粘连是腹部手术或炎症后形成的纤维带,会导致术后死亡率和发病率。本研究旨在评估布比卡因、生理盐水和两种剂量的利多卡因在腹腔灌洗后的效果,并比较它们在减少大鼠腹腔粘连方面的作用。

方法

在一项双盲、随机、安慰剂对照的临床试验中,50只雌性大鼠被麻醉,将壁腹膜刮擦以引起点状出血。大鼠被随机分为五组:生理盐水组、2%利多卡因(3和6mg/kg)组、0.25%布比卡因(2mg/kg)组和对照组(不冲洗)。在剖腹手术期间用适当的溶液冲洗腹腔。两周后,进行再次剖腹手术。记录并比较粘连的数量、质量、严重程度和评分。

结果

对照组粘连的数量和质量显著高于利多卡因(6mg/kg)组和布比卡因组。生理盐水组粘连的质量高于利多卡因(6mg/kg)组和布比卡因组。利多卡因3mg/kg组与6mg/kg组之间以及利多卡因3mg/kg组与生理盐水组之间粘连的严重程度低于对照组。

结论

在首次剖腹手术中使用利多卡因(6mg/kg)和布比卡因灌洗可减少因粘连带形成导致的腹腔梗阻。

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