腹腔内注射罗哌卡因对妇科腹腔镜术后镇痛效果观察（附60例报告）

目的观察妇科腹腔镜手术后腹腔内注射罗哌卡因用于术后镇痛的可行性和效果。方法采用随机、安慰剂对照和双盲的研究方法,将120例择期行腹腔镜下妇科手术患者分为A、B两组,A、B组术毕腹腔内分别注入0.5%罗哌卡因20ml、生理盐水20ml,术后4、8、12、24、48h对切口、内脏、肩部三个部位通过视觉模拟评分法(VAS)评估疼痛程度,VAS>4者予镇痛药处理。记录两组患者额外镇痛药的需要量并观察比较两组病人围手术期肺功能改变及术后恶心呕吐(PONV)等不良反应的发生情况。结果术后各时段各部位A组病人VAS评分均小于B组(P<0.05)。A组术后额外镇痛药用量小于B组。两组病人在围手术期肺功能及恶心呕吐等方面差异无统计学意义(P>0.05)。结论妇科腹腔镜手术后腹腔内注射0.5%罗哌卡因镇痛安全、有效、并发症少。

Intraperitoneal injection of ropivacaine for postoperative analgesia in gynecologic laparoscope patients

Objective To evaluate the analgesic effects of intraperitoneal injection of ropivacaine at the end of laparoscope surgery in gynecologic patients.Methods One hundred and twenty gynecologic patients undergoing elective laparoscope surgery were randomly divided into two groups equally:group A(n=60)introperitoneal 0.5% ropivacaine 20 ml at the end of laparoscope surgery,while group B(n=60)0.9% normal saline 20 ml.Pain score was assessed by using a visual analog scale(VAS)at 4,8,12,24,48 hours after surgery.Intravenous analgesic drugs was given if VAS>4.Postoperative nausea and vomiting(PONV)was rated.The peak expiratory flow was measured preoperatively and three hours after surgery.The additional analgesic drugs consumption after surgery and postoperative nausea,vomiting were also recorded.Results The pain score of group A is less than group B significantly at vary time after surgery(P<0.05).No patients in group A consumed additional analgesic,significantly less than group B.No influence had happened about ropivacaine on peak expiratory flow,postoperative nausea,or vomiting.Conclusion Introperitoned instillation of 0.5% ropivacaine after laparoscope surgery in gynecology is safe and effective to prevent postoperative pain,moreover,complications are rare.