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腹腔镜胆囊切除术后单纯腹腔内注射左旋布比卡因或联合右美托咪定用于术后镇痛

Intraperitoneal Levobupivacaine Alone or with Dexmedetomidine for Postoperative Analgesia after Laparoscopic Cholecystectomy.

作者信息

Beder El Baz Mohamed Maher, Farahat Tamer El Metwally

机构信息

Department of Anesthesiology, Faculty of Medicine, Mansoura University, Mansoura, Egypt.

出版信息

Anesth Essays Res. 2018 Apr-Jun;12(2):355-358. doi: 10.4103/aer.AER_205_17.

DOI:10.4103/aer.AER_205_17
PMID:29962597
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6020555/
Abstract

BACKGROUND AND AIMS

Local anesthetic injection in the peritoneal cavity decreases intensity of postoperative pain after laparoscopic surgeries. We compared adding dexmedetomidine to intraperitoneal levobupivacaine in patients undergoing laparoscopic cholecystectomy.

METHODS

A total of 105 patients were included in this prospective, double-blinded, randomized study. Patients were randomly divided into three equal sized ( = 35) study groups. Group C patients received intraperitoneal 40 ml normal saline as controlled group. Group L was given 40 ml 0.25% levobupivacaine. Group LD received 40 ml 0.25% levobupivacaine + dexmedetomidine 1 μg/kg. The degree of postoperative pain was measured by visual analog scale (VAS) score. The time of first analgesic demand was recorded and also total dose of painkiller in the first 24 h and postoperative complications were collected. SPSS version 16 was used for statistical analysis. < 0.05 was considered statistically significant.

RESULTS

Postoperative VAS at different time intervals was significantly lower, time to the first demand of painkiller (min) was longer (30.2 ± 14.4, 45.9 ± 20.1, and 56.5 ± 13.2), and total painkiller consumption (mg) was lower (203.5 ± 42.9, 117.8 ± 63.7, and 46.3 ± 41.3) in Group LD than Group L than Group C.

CONCLUSION

Adding dexmedetomidine to intraperitoneal levobupivacaine is superior to and gives better results than levobupivacaine alone in patients undergoing laparoscopic cholecystectomy.

摘要

背景与目的

在腹腔内注射局部麻醉剂可降低腹腔镜手术后的术后疼痛强度。我们比较了在接受腹腔镜胆囊切除术的患者中,在腹腔内左旋布比卡因中添加右美托咪定的效果。

方法

本前瞻性、双盲、随机研究共纳入105例患者。患者被随机分为三个等规模(每组n = 35)的研究组。C组患者接受腹腔内注射40 ml生理盐水作为对照组。L组给予40 ml 0.25%左旋布比卡因。LD组接受40 ml 0.25%左旋布比卡因+右美托咪定1 μg/kg。通过视觉模拟量表(VAS)评分来测量术后疼痛程度。记录首次镇痛需求时间以及前24小时内止痛药的总剂量,并收集术后并发症。使用SPSS 16版进行统计分析。P < 0.05被认为具有统计学意义。

结果

与L组和C组相比,LD组在不同时间间隔的术后VAS显著更低,首次止痛药需求时间(分钟)更长(30.2 ± 14.4、45.9 ± 20.1和56.5 ± 13.2),且止痛药总消耗量(毫克)更低(203.5 ± 42.9、117.8 ± 63.7和46.3 ± 41.3)。

结论

在接受腹腔镜胆囊切除术的患者中,在腹腔内左旋布比卡因中添加右美托咪定比单独使用左旋布比卡因更具优势且效果更佳。

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A randomized, double-blind, controlled trial on non-opioid analgesics and opioid consumption for postoperative pain relief after laparoscopic cholecystectomy.一项关于非阿片类镇痛药与阿片类药物使用量对腹腔镜胆囊切除术后疼痛缓解效果的随机、双盲、对照试验。
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