腹腔镜胆囊切除术后腹腔内灌注罗哌卡因和罗哌卡因加右美托咪定进行术后镇痛的比较:一项前瞻性研究

Priyanka Sharma, Priyanka Saini, MEGHA SHARMA, Manish Khandelwal
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摘要

目的:腹腔镜胆囊切除术与开腹胆囊切除术相比,具有疼痛轻、恢复快等优点。腹腔内注射局麻药是减轻腹腔镜手术后疼痛强度的一种廉价、简便和无创的方法。本研究比较了在全身麻醉下进行腹腔镜胆囊切除术的患者术后腹腔内灌注 0.5% 罗哌卡因和 0.5% 罗哌卡因加右美托咪定(1µg/kg)的镇痛效果。方法将 86 名患者平均分成两组。R组患者接受20毫升0.5%盐酸异压罗哌卡因+5毫升NS,RD组患者接受20毫升0.5%盐酸异压罗哌卡因+1µg/kg盐酸右美托咪定。溶液用生理盐水稀释,总容量为 25 毫升。术中记录血流动力学参数 术后使用视觉模拟量表(VAS)评估患者在 30 分钟、2、4、8、12 和 24 小时内的疼痛情况。研究结果研究参与者的基线人口统计学特征相似。RD 组的平均镇痛时间(10.05±6.916 小时)明显高于 R 组(5.59±6.8 小时)(P=0.003)。与 RD 组(75±36.6)相比,R 组的平均镇痛抢救剂量(130.81±61.44)明显更高(P<0.001)。在不同的时间间隔,R 组的 VAS 评分明显高于 RD 组。结论:我们认为,腹腔注射罗哌卡因联合右美托咪定的术后镇痛效果优于单用罗哌卡因。
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A COMPARISON OF INTRAPERITONEAL INSTILLATION OF ROPIVACAINE AND ROPIVACAINE WITH DEXMEDETOMIDINE FOR POSTOPERATIVE ANALGESIA FOLLOWING LAPAROSCOPIC CHOLECYSTECTOMY: A PROSPECTIVE STUDY
Objective: laparoscopic cholecystectomy surgeries are having advantages over open cholecystectomy with less pain and quick recovery. Intraperitoneal route of administration of a local anaesthetic is a cheap, easy and non-invasive method of reducing the intensity of post laparoscopic pain. This study compared the postoperative analgesic effect of intraperitoneal instillation of ropivacaine 0.5% and ropivacaine 0.5% with dexmedetomidine (1µg/kg) in patients undergoing laparoscopic cholecystectomy under general anaesthesia. Methods: Total 86 patients were divided equally in 2 groups. Patients in group R received 20 ml 0.5% isobaric ropivacaine hydrochloride+5 ml NS where in Group RD, patients received 20 ml 0.5% isobaric ropivacaine hydrochloride with 1µg/kg dexmedetomidine hydrochloride. Solution was diluted with normal saline to make a total volume 25 ml. Hemodynamic parameters were noted during surgery Postoperatively, patient was assessed for pain using the visual analogue scale (VAS) at 30 min, then 2,4,8,12 and 24 h. Total analgesic consumption in the first 24 h also compared. Results: Baseline demographic profile of study participants were similar. Mean duration of analgesia was significantly higher in group RD (10.05±6.916 h) as compared to group R (5.59±6.8) (p=0.003). Mean dose of rescue analgesia was significantly higher in group R (130.81±61.44) as compared to group RD (75±36.6) (p<0.001). VAS score was significantly higher in group R as compared to group RD at different time intervals. Conclusion: We concluded that intraperitoneal Ropivacaine with Dexmedetomidine produced postoperative analgesia better than ropivacaine alone.
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