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学科主题: 临床医学
题名:
Combined incisional ropivacaine infiltration and pulmonary recruitment manoeuvre for postoperative pain relief after diagnostic hysteroscopy and laparoscopy
作者: Liu Huili1; Ma Caihong2; Zhang Xiaoqing1; Yu Chen1; Yang Yan1,2; Song Xueling2; Tang Yi; Guo Xiangyang1
关键词: analgesia ; postoperative care ; ropivacaine ; local anaesthesia ; pulmonary recruitment manoeuvre
刊名: CHINESE MEDICAL JOURNAL
发表日期: 2014-03-05
DOI: 10.3760/cma.j.issn.0366-6999.20131732
卷: 127, 期:5, 页:825-829
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Medicine, General & Internal
研究领域[WOS]: General & Internal Medicine
关键词[WOS]: RANDOMIZED-CONTROLLED-TRIAL ; SHOULDER PAIN ; POSTLAPAROSCOPIC SHOULDER ; AMBULATORY SURGERY ; LOCAL-ANESTHETICS ; CHOLECYSTECTOMY ; MANAGEMENT ; ANALGESIA
英文摘要:

Background Preoperative incisional local anaesthesia with ropivacaine is a common method of providing post-laparoscopy pain relief. The pulmonary recruitment manoeuvre also provides pain relief, but the combined effect of these two methods on pain following laparoscopic procedures has not been reported. We investigated the efficacy of combining local anaesthetic infiltration of ropivacaine with pulmonary recruitment manoeuvre on postoperative pain following diagnostic hysteroscopy and laparoscopy.

Methods This prospective, randomized, controlled study involved 60 patients divided into two groups (n=30, each). Group 1 received 20 ml of 0.5% ropivacaine injected peri-incisionally preoperatively, with intra-abdominal carbon dioxide removed by passive deflation. Group 2 received 20 ml of 0.5% ropivacaine injected peri-incisionally with five manual inflations of the lungs with a positive-pressure ventilation of 40 cmH(2)O at the end of surgery. The last inflation was held for 5 seconds. The intensity of postoperative incisional and shoulder pain was evaluated using a numerical rating scale at 0, 2, 4, 8, 12, 24 and 48 hours postoperatively by an independent blinded anaesthesiologist. Tramadol was given postoperatively for analgesia.

Results Compared with group 1, incisional ropivacaine infiltration combined with pulmonary recruitment manoeuvre significantly reduced dynamic pain at 0 hour, 4 hours, and 24 hours postoperatively (4.1 +/- 2.2 vs. 2.1 +/- 1.9, P=0.002; 2.7 +/- 2.7 vs. 1.2 +/- 1.3, P=0.035; and 3.5 +/- 2.1 vs. 2.1 +/- 1.8, P=0.03, respectively). Static incisional pain was significantly relieved at 0 hour, 2 hours, and 24 hours postoperatively (3.1 +/- 1.7 vs. 1.6 +/- 1.3, P=0.001; 1.4 +/- 1.3 vs. 0.5 +/- 0.8, P=0.012; and 2.3 +/- 1.9 vs. 1.0 +/- 1.5, P=0.038, respectively). Group 2 had more patients without shoulder pain (P<0.05) and fewer requiring tramadol (P<0.05).

Conclusion Ropivacaine with pulmonary recruitment manoeuvre provided simple and effective pain relief after diagnostic hysteroscopy and laparoscopy.

语种: 英语
WOS记录号: WOS:000333498600006
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/56738
Appears in Collections:北京大学第三临床医学院_麻醉科_期刊论文

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作者单位: 1.Peking Univ, Hosp 3, Dept Anesthesiol, Beijing 100191, Peoples R China
2.Peking Univ, Hosp 3, Reprod Med Ctr, Beijing 100191, Peoples R China

Recommended Citation:
Liu Huili,Ma Caihong,Zhang Xiaoqing,et al. Combined incisional ropivacaine infiltration and pulmonary recruitment manoeuvre for postoperative pain relief after diagnostic hysteroscopy and laparoscopy[J]. CHINESE MEDICAL JOURNAL,2014,127(5):825-829.
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