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利多卡因生理盐水与生理盐水冲洗乳房肿块切除腔对术后急性疼痛影响的对比研究

Comparative study of lidocaine- saline versus saline as washout for lumpectomy cavity on acute postoperative pain.

作者信息

Rezagholi Payman, Nasseri Karim, Barzanji Arvin, Rahmani Khaled, Foroughi Asra, Moayeri Hassan

机构信息

Department of Operating Room, School of Nursing and Midwifery, Besat Hospital, Kurdistan University of Medical Sciences, Sanandaj, Iran.

Department of Anesthesiology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.

出版信息

Heliyon. 2024 Oct 11;10(20):e39265. doi: 10.1016/j.heliyon.2024.e39265. eCollection 2024 Oct 30.

Abstract

PURPOSE

This study aimed to evaluate the impact of lidocaine-saline solution compared to saline alone for washing out the lumpectomy cavity, focusing on its effect on acute postoperative pain-a prevalent and significant concern among patients undergoing breast surgery.

METHODS

In this comparative study, 72 patients scheduled for lumpectomy surgery were randomly assigned to either the lidocaine-saline or saline group. The lidocaine-saline group was administered a washout of the lumpectomy cavity with 2 % lidocaine at a dosage of 1.75 mg/kg in 0.9 % normal saline, whereas the saline group received a washout with an equivalent volume of 0.9 % normal saline. We recorded the participants' basic characteristics, heart rate, blood pressure, the incidence and intensity of pain (measured by the visual analogue scale), and the usage of postoperative analgesics.

RESULTS

The two study groups did not differ significantly in their basic characteristics, heart rate and blood pressure. The saline group had significantly higher pain intensity than the lidocaine-saline group at 30 min after surgery (4.61 vs. 2.88, P < 0.0001) and at all other time points (P < 0.001). The saline group also took the first dose of analgesics earlier than the lidocaine-saline (46.66 Vs. 170.55 min, P < 0.001) and used a significantly higher mean dose of meperidine (77.50 mg vs 33.47 mg, P < 0.001).

CONCLUSION

The use of a lidocaine-saline wash during lumpectomy procedures can significantly reduce postoperative pain and lower the necessity for analgesics in patients who have undergone breast surgery.

摘要

目的

本研究旨在评估利多卡因 - 盐水溶液与单纯盐水冲洗乳腺肿块切除腔的效果对比,重点关注其对术后急性疼痛的影响,这是接受乳房手术患者普遍且重大的关切问题。

方法

在这项对比研究中,72例计划接受肿块切除术的患者被随机分为利多卡因 - 盐水组或盐水组。利多卡因 - 盐水组用含2%利多卡因(剂量为1.75mg/kg)的0.9%生理盐水冲洗乳腺肿块切除腔,而盐水组用等量的0.9%生理盐水冲洗。我们记录了参与者的基本特征、心率、血压、疼痛的发生率和强度(通过视觉模拟量表测量)以及术后镇痛药的使用情况。

结果

两个研究组在基本特征、心率和血压方面无显著差异。盐水组在术后30分钟(4.61对2.88,P<0.0001)及所有其他时间点的疼痛强度均显著高于利多卡因 - 盐水组(P<0.001)。盐水组服用第一剂镇痛药的时间也比利多卡因 - 盐水组早(46.66对170.55分钟,P<0.001),且哌替啶的平均使用剂量显著更高(77.50mg对33.47mg,P<0.001)。

结论

在乳腺肿块切除术中使用利多卡因 - 盐水冲洗可显著减轻术后疼痛,并降低接受乳房手术患者对镇痛药的需求。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b38/11532270/f0473f2f3ff4/gr1.jpg

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