| 郑行,蔡秀军.切口持续镇痛方法对腹部术后镇痛效果和短期预后影响的评价[J].Chinese journal of Epidemiology,2013,34(11):1125-1127 |
| 切口持续镇痛方法对腹部术后镇痛效果和短期预后影响的评价 |
| Study Oil the effectiveness of continuous local infiltration analgesia and related short-termprognosis after laparotomy |
| Received:August 20, 2013 |
| DOI：10.3760/cma.j.issn.0254-6450.2013.011.018 |
| KeyWord: 镇痛 自控镇痛 局部麻醉 切口感染 |
| English Key Word: Analgesia Patient control analgesia Local anesthesia Incision infection |
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| Abstract: |
| 目的评估上腹部术后通过弹性输注泵对切12持续浸润局部麻醉给药方法的镇痛效果，及是否能够减少阿片类药物的用量。方法回顾分析2012年1-9月接受上腹部手术患者285例，其中144例术后使用弹性输注泵行切口持续浸润的镇痛管理(LA)，141例为白控静脉镇痛管理(PCA)，评估两组静息状态和活动后视觉模拟评分法(VAS)评分、阿片类药物用量、肠道功能恢复情况、切口愈合以及并发症情况。结果两组患者术后48 h内VAS评分差异无统计学意义，术后72 h静息状态VAS评分LA组高于PCA组(P<0.001)。LA组术后72 h内阿片类药物用量低于PCA组(P<0.01)，且术后恶心、呕吐发生率更低(P<0.001)，肛门排气、排便早于PCA组(P<0.01)，切口渗液发生率较PCA组高(P<0.001)，但切口感染发生率差异无统计学意义。结论开腹术后48 h内使用持续镇痛装置可达到与自控静脉镇痛相似的镇痛效果，但明显减少阿片类药物用量，并有利于早期肠道功能恢复。 |
| English Abstract: |
| 0bjective To evaluate the effectiveness of incisional infusion through localanesthetics under a continuous—infusion elastomeric pump for the management of postoperative painafter laparotomy,on reducing the amount of opioids being used after surgery.Methods Weperformed a retrospective comparative analysis on 285 patients who had undergone laparotomiesbetween January 2012 and September 2012.Among those patients,144 took a continuous-infusionelastomeric pump to receive local anesthetic(LA)at the incisional area for postoperative painmanagement while another 141 patients took‘patient-controlled’intravenous analgesia(PCA).Datawere reviewed on iterns as：visual analog pain scores(VAS)during both resting and active situation,mean opioid use。bowel function,condition of incision and complications etc.Results Both groupsshowed similar VAS scores for the first 48 hours post.operation.However.in the LA group.VASscores appeared significantly higher within the first 72 hours(PP<0.0 1).1ess symptoms as postoperative nausea or vomiting(P<0.00 1),with earlier recovery ofbowelfunction(Petc.when compared to the PCA group.No significant difierence found on thejncidence rates of wound infection other than,a higher rate of incisional drainage(PConclusion Continuous infusion of 10cal anesthetic under an elastomericinfusion pump post the laparotomy,a similar analgesic effect could be seen on those patient-controlledintravenous analgesia within the first 48 hours,it could also reduce opioid consumption andpostoperative symptoms as nausea or vomiting,which all appeared to be associated with the earlierrecovery of bowel function. |
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