Rezvani Majid, Abrishamkar Saeid, Tabesh Homayoun, Namazi Ali, Mahabadi Amir, Aeinfar Masoud, Nourian Niloufar
Department of Neurosurgery, Isfahan University of Medical Sciences, Isfahan, Iran.
Adv Biomed Res. 2018 Jan 22;7:2. doi: 10.4103/abr.abr_161_15. eCollection 2018.
As marcaine is administered to a great extent due to minor complications and reasonable expenses and as discectomy is prevalently used in Iran, this study makes a comparison between effect of marcaine alone, lidocaine alone, and marcaine plus lidocaine on pain relief of patients undergoing lumbar disc open surgery.
In a clinical trial study, 192 patients were selected and randomly divided into four groups. Patients in Groups 1-4 received 0.5 ml marcaine during surgery, 5 ml lidocaine 2% before incision, 5 ml lidocaine 2% before incision plus 5 ml marcaine during surgey and normal saline, respectively. After patients gained knowledge of visual analog scale (VAS) criteria, their severity of pain was measured and was recorded in their profiles, along with demographic details and history of diseases. After surgery and their transfer to their rooms, their severity of pain was measured and recorded again by using VAS criteria. Finally, difference between the four groups was compared by SPSS software.
The mean (±standard deviation) of postoperative pain in marcaine + lidocaine, marcaine, lidocaine, and normal saline was 3.5 ± 1.3, 3.5 ± 1.6, 36.1.9, and 4.2 ± 1.8, respectively, and we did not observe any significant difference in severity of pain after surgery in these groups ( = 0.15). The highest and lowest degree of satisfaction occurred in marcaine-lidocaine group and control group, respectively, (40 patients [83.3%] vs. 25 patients [52.1%]).
Lidocaine-marcaine treatment reduces the need to opiates in cases of postoperative pain relief of discectomy and provides patients with great satisfaction.
由于丁哌卡因因并发症少且费用合理而被广泛使用，并且椎间盘切除术在伊朗普遍应用，本研究比较了单独使用丁哌卡因、单独使用利多卡因以及丁哌卡因加利多卡因对接受腰椎间盘开放手术患者疼痛缓解的效果。
在一项临床试验研究中，选取192例患者并随机分为四组。第1 - 4组患者在手术期间分别接受0.5毫升丁哌卡因、切开前接受5毫升2%利多卡因、切开前接受5毫升2%利多卡因加手术期间接受5毫升丁哌卡因以及生理盐水。患者了解视觉模拟评分（VAS）标准后，测量其疼痛严重程度并记录在其病历中，同时记录人口统计学细节和疾病史。手术后患者被转移至病房时，再次使用VAS标准测量并记录其疼痛严重程度。最后，使用SPSS软件比较四组之间的差异。
丁哌卡因加利多卡因组、丁哌卡因组、利多卡因组和生理盐水组术后疼痛的均值（±标准差）分别为3.5±1.3、3.5±1.6、3.9±1.9和4.2±1.8，并且我们未观察到这些组术后疼痛严重程度有任何显著差异（P = 0.15）。满意度最高和最低的分别是丁哌卡因 - 利多卡因组和对照组（40例患者[83.3%]对25例患者[52.1%]）。
利多卡因 - 丁哌卡因治疗在椎间盘切除术后疼痛缓解的情况下减少了对阿片类药物的需求，并为患者提供了很高的满意度。
