腹腔镜胆囊切除手术中静脉注射木质素后插管、拔管和术后镇痛的血流动力学反应:随机对照研究

Srikanth Gujja, Varun Arora, Sravanthi Yelagandula, Chanchal Bhandari, Mittapalli Jeevanbabu
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摘要

摘要:目的:评估静脉注射木质素对腹腔镜胆囊切除手术中插管、拔管和术后镇痛的血流动力学反应的影响:评估腹腔镜胆囊切除术中静脉注射木质素对插管、拔管和术后镇痛的血流动力学反应的影响。方法:这项前瞻性、随机、双盲研究在泰米尔纳德邦三级医院的择期腹腔镜胆囊切除手术患者中进行。A 组(60 人)接受 0.9% 生理盐水围手术期静脉输注,B 组(60 人)接受不含防腐剂的 2% 木质卡因(20 毫克/毫升)静脉输注,记录两组患者插管、拔管和术后镇痛时的血流动力学反应。还比较了 VAS 评分和无痛期。结果在喉镜检查和插管过程中,两组患者的脉搏(PR)和平均动脉压(MAP)均明显升高,但木质素组的升高幅度明显低于生理盐水组(P<0.0001)。(同样,两组患者在拔管时 PR 和 MAP 均明显升高。(p<0.0001)然而,与生理盐水组相比,木质素组两个参数的上升幅度都明显较小。(p<0.0001)木质素组术后即刻的 VAS 评分优于生理盐水组。普通生理盐水组的平均无痛时间不到一小时,而木质素组约为 4 小时。(P<0.0001)结论:本研究得出结论,静脉注射木质素可明显延长术后无痛时间。因此,对于那些无法承受硬膜外阻滞的患者,输注木质素卡因是术后镇痛的更好选择。
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Haemodynamic responses to intubation, extubation and post‐operative analgesia after intravenous lignocaine in laparoscopic cholecystectomy surgeries: a randomized control study
ABSTRACT: Objectives: To evaluate the effect of intravenous lignocaine on haemodynamic responses to intubation, extubation and post‐operative analgesia in laparoscopic cholecystectomy surgeries. Methods: This prospective, randomized, double blinded study was conducted in patients for elective laparoscopic cholecystectomy surgery in tertiary care hospital of Tamil Nadu. Group A (n=60) received 0.9% normal saline for perioperative intravenous infusion and Group B (n=60) received preservative free lignocaine 2% (20mg/ml) as intravenous infusion Hemodynamic responses were recorded to intubation, extubation and post‐operative analgesia in both groups. VAS scores and pain free period were also compared. Results: Pulse rate (PR) and mean arterial pressure (MAP) were significantly increased in both the groups during laryngoscopy and intubation, though the rise of both in lignocaine group was significantly less than normal saline group. (p<0.0001)  Similarly, both PR and MAP were significantly increased during extubation in both the groups. (p<0.0001) However, the rise of both the parameters in lignocaine group was significantly less as compared to normal saline group. (p<0.0001) VAS scores in immediate post operative period were better in lignocaine group than normal saline group. The mean pain free period was less than an hour in normal saline group, while it was approximately 4 hours in lignocaine group. (p<0.0001) Conclusions: This study concluded that i.v infusion of lignocaine had significantly increased the pain free period post operatively. So those who are not affordable for epidural block, lignocaine i.v infusion is better alternative for post operative analgesia.
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