腹腔镜胆囊切除术后腹腔内灌注布比卡因与普通生理盐水止痛的比较。

Laparoscopic Cholecystectomy, H. Jalal, M. Murtaza, Noor Fatima, A. Khalid
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摘要

目的评估布比卡因局部冲洗是否能减轻胆囊切除术后的疼痛。研究设计:前瞻性随机对照试验。研究地点拉合尔沙赫达拉政府教学医院外科。时间: 2020年6月至2022年12月2020 年 6 月至 2022 年 12 月。研究方法本研究将 86 名参与者分为两组,每组 43 人(布比卡因与无布比卡因)。对照组(A 组)在右侧膈下区域和端口部位浸润 15 毫升 0.5% 布比卡因,B 组则使用生理盐水。结果本研究共纳入 86 人。此外,两组患者的平均年龄和中位年龄(月)分别为 47.7 ± 8.97 岁和 47 岁(18-60 岁),男性患者占多数(59 人,68.6%)。此外,在 0-3 小时、3-5 小时、5-7 小时和 7-10 小时时,视觉模拟量表上的疼痛评分平均值差异有统计学意义(P 值 < 0.05)。同样,在超过 3 至 5 小时、超过 7 小时和超过 10 小时后,视觉模拟量表上的疼痛评分平均值差异也有统计学意义(P 值 < 0.05)。结论因此,我们推断腹腔镜胆囊切除术后腹腔内和局部浸润布比卡因可显著降低术后不适程度和对镇痛药的需求。
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Comparison of intraperitoneal instillation of Bupivacaine vs Normal Saline for postoperative pain relief after laparoscopic cholecystectomy.
Objective: To evaluate whether local irrigation of Bupivacaine reduces post-operative pain after cholecystectomy. Study Design: Prospective, Randomized Controlled Trial. Setting: Department of Surgery, Government Teaching Hospital, Shahdara Lahore. Period: June 2020 to December 2022. Methods: For this study, 86 participants were divided into two groups, each containing 43 participants (Bupivacaine vs. no Bupivacaine). The control group (Group A) received an infiltration of 15 ml of 0.5% bupivacaine in the sub-diaphragmatic region on the right side and at port sites, while normal saline was administered to Group B. The Visual Analogue Pain Score Scale was employed to assess pain levels at 0-3, 3-5, 5-7, and above 7-10 hours post-surgery (VAS). Results: In this study, the total number of included individuals was 86. Moreover, the overall mean and median ages in months for both groups were 47.7 ± 8.97 and 47 (18-60) respectively, with the majority of patients being male (59 individuals, 68.6%). Furthermore, there was a statistically significant mean difference in pain scores on the visual analogue scale at 0–3 hours, 3–5 hours, 5–7 hours, and 7–10 hours (p-value < 0.05). Similarly, there was a statistically significant mean difference in pain scores on the visual analogue scale after more than three to five hours, more than seven hours, and more than ten hours (p-value < 0.05). Conclusion: Consequently, we inferred that intraperitoneal and local infiltration of Bupivacaine following laparoscopic cholecystectomy significantly reduced the level of postoperative discomfort and the requirement for analgesics.
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