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术中静脉输注利多卡因优化术后疼痛管理并加速胃肠功能恢复:回顾性队列研究

卫佼佼 张越伦 卢素芳 任丽英 王英丽 申乐 黄宇光

卫佼佼, 张越伦, 卢素芳, 任丽英, 王英丽, 申乐, 黄宇光. 术中静脉输注利多卡因优化术后疼痛管理并加速胃肠功能恢复:回顾性队列研究[J]. 协和医学杂志, 2019, 10(6): 600-604. doi: 10.3969/j.issn.1674-9081.2019.06.009
引用本文: 卫佼佼, 张越伦, 卢素芳, 任丽英, 王英丽, 申乐, 黄宇光. 术中静脉输注利多卡因优化术后疼痛管理并加速胃肠功能恢复:回顾性队列研究[J]. 协和医学杂志, 2019, 10(6): 600-604. doi: 10.3969/j.issn.1674-9081.2019.06.009
Jiao-jiao WEI, Yue-lun ZHANG, Su-fang LU, Li-ying REN, Ying-li WANG, Le SHEN, Yu-guang HUANG. Intraoperative Intravenous Lidocaine Infusion Optimized Postoperative Pain Control and Enhanced Recovery of Gastrointestinal Function after Surgery: A Retrospective Cohort Study[J]. Medical Journal of Peking Union Medical College Hospital, 2019, 10(6): 600-604. doi: 10.3969/j.issn.1674-9081.2019.06.009
Citation: Jiao-jiao WEI, Yue-lun ZHANG, Su-fang LU, Li-ying REN, Ying-li WANG, Le SHEN, Yu-guang HUANG. Intraoperative Intravenous Lidocaine Infusion Optimized Postoperative Pain Control and Enhanced Recovery of Gastrointestinal Function after Surgery: A Retrospective Cohort Study[J]. Medical Journal of Peking Union Medical College Hospital, 2019, 10(6): 600-604. doi: 10.3969/j.issn.1674-9081.2019.06.009

术中静脉输注利多卡因优化术后疼痛管理并加速胃肠功能恢复:回顾性队列研究

doi: 10.3969/j.issn.1674-9081.2019.06.009
详细信息
    通讯作者:

    申乐 电话:010-69152026, E-mail:pumchshenle@aliyun.com

  • 中图分类号: R614;R971

Intraoperative Intravenous Lidocaine Infusion Optimized Postoperative Pain Control and Enhanced Recovery of Gastrointestinal Function after Surgery: A Retrospective Cohort Study

More Information
  • 摘要:   目的  观察腹盆部手术中持续静脉输注利多卡因对术后疼痛管理及胃肠道功能恢复的影响。  方法  回顾性收集并分析2017年1月至2019年5月在北京协和医院接受全麻下腹盆部手术患者的临床资料, 试验组患者在全身麻醉的同时联合静脉输注利多卡因, 对照组采用传统全身麻醉模式。比较两组术后24 h内舒芬太尼的用量、静息及活动状态的疼痛视觉模拟评分(visual analogue score, VAS)、自控镇痛泵按压次数、恶心呕吐及排气情况。  结果  与对照组相比, 试验组术后24 h内舒芬太尼用量和镇痛泵按压次数均减少[(0.0372±0.0137)μg/(kg·h)比(0.0498±0.0447)μg/(kg·h), t=-2.190, P=0.030;(7.4±6.7)次比(11.1±10.6)次, t=-2.257, P=0.027], 术后24 h内的静息及活动状态疼痛VAS评分≤ 3分者比例均更高(97.0%比85.5%, χ2=3.938, P=0.047;68.7%比47.3%, χ2=5.710, P=0.017), 肠道排气率更高(26.9%比5.5%, χ2=9.717, P=0.002), 但恶心、呕吐发生率未见统计学差异。  结论  腹盆部手术术中输注利多卡因可能有助于术后疼痛管理, 加速胃肠道功能恢复。
    利益冲突  无
  • 图  1  两组接受腹盆部手术患者纳入流程图

    USPSTF:PCA:患者自控镇痛

    表  1  两组腹盆部手术患者一般临床资料比较

    指标 对照组(n=55) 试验组(n=67) t值/χ2 P
    年龄(x±s,岁)(n=100) 49.6±15.3 52.8±14.9 -1.164 0.247
    BMI(x±s,kg/m2) 22.9±3.5 23.2±3.9 -0.406 0.685
    性别[n(%)]     0.058 0.810
      女性 30(54.5) 38(56.7)    
      男性 25(45.5) 29(43.3)    
    ASA分级[n(%)]     0.007 0.935
      Ⅰ~Ⅱ级 49(89.1) 60(89.6)    
      Ⅲ级 6(10.9) 7(10.4)    
    手术时间(x±s,h) 194.9±83.6 179.0±83.0 1.053 0.295
    麻醉时间(x±s,h) 215.9±85.1 205.9±84.0 0.004 0.516
    手术种类[n(%)]     1.818 0.178
      开服 22(40.0) 35(52.2)    
      微创 33(60.0) 32(47.8)    
    BMI:体质量指数,ASA:美国麻醉医师学会
    下载: 导出CSV

    表  2  两组腹盆部手术患者术后24h内舒芬太尼自控镇痛情况比较

    指标 对照组(n=55) 试验组(n=67) t P
    舒芬太尼用量[x±s, μg/(kg·h)] 0.049 8±0.044 7 0.037 2±0.013 7 -2.190 0.030
    自主按压次数(x±s, 次) 11.1±10.6 7.4±6.7 -2.257 0.027
    下载: 导出CSV

    表  3  两组腹盆部手术患者术后24 h静息及活动状态疼痛视觉模拟评分比较[n(%)]

    指标 对照组(n=55) 试验组(n=67) χ2 P
    静息状态     3.938 0.047
      ≤3分 47(85.5) 65(97.0)    
      >3分 8(14.5) 2(3.0)    
    活动状态     5.710 0.017
      ≤3分 26(47.3) 46(68.7)    
      >3分 29(52.7) 21(31.3)    
    下载: 导出CSV

    表  4  两组腹盆部手术患者术后24h胃肠道功能恢复情况比较[n(%)][n(%)]

    指标 对照组(n=55) 试验组(n=67) χ2 P
    恶心     3.335 0.551
      有 14(25.5) 14(20.9)    
      无 41(74.5) 53(79.1)    
    呕吐     0.859 0.354
      有 3(5.5) 8(11.9)    
      无 52(94.5) 59(88.1)    
    排气     9.717 0.002
      有 3(5.5) 18(26.9)    
      无 52(94.5) 49(73.1)    
    下载: 导出CSV
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  • 收稿日期:  2019-07-31
  • 刊出日期:  2019-11-30

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