Zhao Liyan, Li Bin, Li Ningkang, Bao Jiamin, Zhu Xiaoning, Hai Kerong
Department of Anesthesiology, People's Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University, Yinchuan, China.
School of Basic Medicine, Ningxia Medical University, Yinchuan, China.
J Obstet Gynaecol Res. 2024 Oct;50(10):1902-1908. doi: 10.1111/jog.16053. Epub 2024 Sep 4.
To assess the effectiveness of intraoperative lidocaine in reducing the incidence of post-laparoscopic shoulder pain (PLSP) after gynecologic laparoscopy.
Patients undergoing total laparoscopic hysterectomy were randomly divided into two groups: the lidocaine group, receiving an initial intravenous dose of lidocaine (1.5 mg/kg) before anesthesia induction, followed by a continuous infusion at 2 mg/kg/h, and the placebo group, receiving saline. The primary endpoint was the determination of PLSP incidence over a 72-h period post-surgery. Secondary endpoints included a comprehensive evaluation of pain intensity, as measured by the Numeric Rating Scale (NRS), for shoulder, abdominal, and incisional pain within a 72-hour period postoperatively. Additionally, the endpoints involved the assessment of Lofencodeine or Parexib Sodium usage frequency, incidence of nausea and vomiting, duration of anesthesia and surgical procedure, as well as the duration of hospital stay.
Our study did not demonstrate any significant benefit in the incidence of PLSP during the postoperative period. PLSP occurred in 14 out of 41 patients (34.1%) in the lidocaine group, compared with 15 out of 41 patients (36.6%) in the placebo group (p = 0.817). Intravenous lidocaine reduced abdominal pain scores and decreased the need for postoperative analgesics within 72 h after surgery. No significant differences were found in incisional and shoulder pain intensity, nausea and vomiting rates, or hospitalization duration between groups.
The infusion of lidocaine did not yield a reduction in the incidence or severity of PLSP in patients undergoing laparoscopic total hysterectomy.
评估术中使用利多卡因对降低妇科腹腔镜术后肩痛（PLSP）发生率的有效性。
接受全腹腔镜子宫切除术的患者被随机分为两组：利多卡因组，在麻醉诱导前静脉注射初始剂量的利多卡因（1.5mg/kg），随后以2mg/kg/h的速度持续输注；安慰剂组，输注生理盐水。主要终点是确定术后72小时内PLSP的发生率。次要终点包括通过数字评分量表（NRS）对术后72小时内肩部、腹部和切口疼痛的疼痛强度进行综合评估。此外，终点还涉及评估洛芬待因或帕瑞昔布钠的使用频率、恶心和呕吐的发生率、麻醉和手术时间以及住院时间。
我们的研究未显示术后PLSP发生率有任何显著益处。利多卡因组41例患者中有14例（34.1%）发生PLSP，而安慰剂组41例患者中有15例（36.6%）发生（p = 0.817）。静脉注射利多卡因降低了腹痛评分，并减少了术后72小时内对术后镇痛药的需求。两组之间在切口和肩部疼痛强度、恶心和呕吐率或住院时间方面未发现显著差异。
对于接受腹腔镜全子宫切除术的患者，输注利多卡因并未降低PLSP的发生率或严重程度。
