Lee Ji Hyun, Cho Sang Hyun, Eoh Kyung Jin, Lee Jung-Yun, Nam Eun Ji, Kim Sunghoon, Kim Sang Wun, Kim Young Tae
Department of Obstetrics and Gynecology, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea.
Obstet Gynecol Sci. 2020 May;63(3):363-369. doi: 10.5468/ogs.2020.63.3.363. Epub 2020 Mar 19.
The umbilicus is a single, painful incisional site on the abdomen during trans-umbilical single-port access laparoscopic surgery. Previously, we found that periumbilical lidocaine could reduce postoperative pain. This study aimed to compare the efficacy of bupivacaine and lidocaine in reducing pain.
We performed a retrospective analysis in a study group (Bupivacaine group, 100 patients who received periumbilical infiltration of bupivacaine before their incisional site repair completion) and control group (Lidocaine group, 100 patients who received lidocaine at their incisional site repair completion). We compared postoperative pain based on the numerical rating scale (NRS) between propensity score-matched Bupivacaine-treated (n=50) and Lidocaine-treated (n=50) patients.
The postoperative pain scores based on the NRS were not significantly different between the 2 groups until 12 hours post-operation. However, 24 hours post-operation, the Bupivacaine group showed significantly lower pain than the Lidocaine group (24 hours, 1.76±1.07 vs. 2.53±1.11 NRS, <0.001; 48 hours, 0.84±0.85 vs. 2.16±0.85 NRS, <0.001).
Periumbilical infiltration of bupivacaine has a longer acting efficacy on reducing postoperative surgical pain than that of lidocaine.
在经脐单孔腹腔镜手术中，脐部是腹部唯一的疼痛切口部位。此前，我们发现脐周利多卡因可减轻术后疼痛。本研究旨在比较布比卡因和利多卡因在减轻疼痛方面的疗效。
我们对一个研究组（布比卡因组，100例在切口部位修复完成前接受脐周布比卡因浸润的患者）和对照组（利多卡因组，100例在切口部位修复完成时接受利多卡因的患者）进行了回顾性分析。我们比较了倾向得分匹配的布比卡因治疗组（n = 50）和利多卡因治疗组（n = 50）患者基于数字评分量表（NRS）的术后疼痛情况。
两组术后基于NRS的疼痛评分在术后12小时内无显著差异。然而，术后24小时，布比卡因组的疼痛明显低于利多卡因组（24小时，NRS分别为1.76±1.07和2.53±1.11，<0.001；48小时，分别为0.84±0.85和2.16±0.85，<0.001）。
脐周浸润布比卡因在减轻术后手术疼痛方面的作用时效比利多卡因更长。
