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学科主题临床医学
Combined incisional ropivacaine infiltration and pulmonary recruitment manoeuvre for postoperative pain relief after diagnostic hysteroscopy and laparoscopy
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
2014-03-05
DOI10.3760/cma.j.issn.0366-6999.20131732
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
引用统计
被引频次:3[WOS]   [WOS记录]     [WOS相关记录]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/56738
专题北京大学第三临床医学院_妇产科
北京大学第三临床医学院_麻醉科
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
推荐引用方式
GB/T 7714
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.
APA Liu Huili.,Ma Caihong.,Zhang Xiaoqing.,Yu Chen.,Yang Yan.,...&Guo Xiangyang.(2014).Combined incisional ropivacaine infiltration and pulmonary recruitment manoeuvre for postoperative pain relief after diagnostic hysteroscopy and laparoscopy.CHINESE MEDICAL JOURNAL,127(5),825-829.
MLA Liu Huili,et al."Combined incisional ropivacaine infiltration and pulmonary recruitment manoeuvre for postoperative pain relief after diagnostic hysteroscopy and laparoscopy".CHINESE MEDICAL JOURNAL 127.5(2014):825-829.
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