ElSharkawy Reem Abdelraouf, Farahat Tamer Elmetwally, Abdelwahab Khaled
Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Mansoura University, Egypt.
Department of General Surgery, Faculty of Medicine, Mansoura University, Egypt.
J Anaesthesiol Clin Pharmacol. 2020 Apr-Jun;36(2):195-200. doi: 10.4103/joacp.JOACP_333_18. Epub 2020 Jun 15.
This study was conducted to compare continuous preperitoneal infusion (CPI) with continuous epidural infusion (CEI) of ropivacaine for pain relief and effect on pulmonary functions after major abdominal and pelvic surgeries.
One hundred patients were randomized into two equal groups. Patients in CPI group ( = 50) received analgesia by continuous infusion of 0.2% ropivacaine, whereas those in the CEI group ( = 50) received continuous epidural infusion of 0.2% ropivacaine. The primary outcome was the first request of analgesia. The secondary outcome was the influence on the pulmonary functions.
The time for the first request of analgesia was longer in the CPI group compared with that in the CEI group (7.3 ± 1.6 vs. 4.1 ± 1.1 h with value = 0.001). The daily dose of morphine was lesser in CPI versus CEI group (11.3 ± 1 against 17.4 ± 0.9 mg). The pulmonary function tests were comparable except peak expiratory flow rate, which was better in CPI (170 ± 5.4) than CEI group (148.1 ± 5.8; with value = 0.001).
Continuous preperitoneal infusion provides a superior analgesic effect than the continuous epidural infusion as regards delayed first request of analgesia, better pain scores, lesser usage of additional analgesics with better respiratory function.
本研究旨在比较罗哌卡因持续腹膜前输注（CPI）与持续硬膜外输注（CEI）用于腹部和盆腔大手术后疼痛缓解及对肺功能的影响。
100例患者随机分为两组，每组50例。CPI组患者接受0.2%罗哌卡因持续输注镇痛，而CEI组患者接受0.2%罗哌卡因持续硬膜外输注。主要结局指标为首次镇痛需求时间，次要结局指标为对肺功能的影响。
CPI组首次镇痛需求时间长于CEI组（7.3±1.6小时对4.1±1.1小时，P值=0.001）。CPI组吗啡日用量少于CEI组（11.3±1毫克对17.4±0.9毫克）。除呼气峰值流速外，两组肺功能测试结果相当，CPI组呼气峰值流速（170±5.4）优于CEI组（148.1±5.8；P值=0.001）。
在延迟首次镇痛需求、更好的疼痛评分、更少的额外镇痛药使用及更好的呼吸功能方面，持续腹膜前输注比持续硬膜外输注提供更优的镇痛效果。
