腹腔注射布比卡因、氢化可的松和硫酸镁不同组合对腹腔镜卵巢囊肿切除术后疼痛缓解的疗效：一项双盲随机对照试验
腹腔注射布比卡因、氢化可的松和硫酸镁不同组合对腹腔镜卵巢囊肿切除术后疼痛缓解的疗效：一项双盲随机对照试验
贵州医科大学 麻醉与心脏电生理课题组
翻译：陈锐 编辑：陈锐 审校：曹莹
本研究的目的是评估腹腔内不同组合用药对腹腔镜单侧卵巢囊肿切除术患者术后疼痛缓解的疗效。
我们进行了一项双盲随机对照试验，纳入接受腹腔镜单侧卵巢囊肿切除术的患者。患者接受以下组合之一（每组30名患者）：I组：接受布比卡因加硫酸镁，II组：布比卡因加氢化可的松，III组：硫酸镁加氢化可的松，IV组：仅接受0.9%的生理盐水。本研究的主要观察指标是在第一天结束前每两小时通过视觉模拟量表 (VAS) 评估术后腹痛和肩痛的严重程度，以及首次术后镇痛的时间。
术后18小时，I组的腹部静态和动态疼痛评分均显着低于其他组（P<0.001）。此外，在大多数评估点上，II组的腹部静态和动态疼痛评分显着低于组III（P<0.05）。I组首次需要镇痛药的时间（336.2±67.54分钟）明显长于其他组（P<0.001）。I组需要两剂或更多剂酮咯酸的患者比例显著低于其他组（P<0.001）。恶心或呕吐患者的比例在研究组之间没有显著差异（P>0.05）。
腹腔镜卵巢囊肿切除术后，腹腔注射布比卡因-镁联合比布比卡因-氢化可的松或镁-氢化可的松联合提供更好的镇痛并减少术后吗啡消耗量。
Gaballah KM, Habeeb RM, Abdallah SI. Efficacy of intraperitoneal bupivacaine, hydrocortisone, and magnesium sulfate in different combinations for pain relief after laparoscopic ovarian cystectomy: a double-blind randomized controlled trial. Minerva Anestesiol 2020;86:14-22. DOI: 10.23736/S0375-9393.19.13550-X)
Efficacy of intraperitoneal bupivacaine,
hydrocortisone, and magnesium sulfate
in different combinations for pain relief
after laparoscopic ovarian cystectomy:
a double-blind randomized controlled trial
ABSTRACT
BACKGROUND: The aim of this study was to assess the efficacy of intraperitoneal different combinations for postoperative pain relief in patients undergoing laparoscopic unilateral ovarian cystectomy.
METHODS: We conducted a double-blind randomized controlled trial that enrolled patients who were included to undergo laparoscopic unilateral ovarian cystectomy. Patients received one of the following combinations (30 patients each): group I: received bupivacaine plus magnesium sulfate, group II: received bupivacaine plus hydrocortisone, group III: received magnesium sulfate plus hydrocortisone, and group IV: received saline 0.9% only. The primary outcomes in the present study were the severity of postoperative abdominal and shoulder pain assessed by visual analog scale (VAS) every two hours till the end of the first day, and time for first postoperative analgesia requirement.
RESULTS: Group I had statistically significant lower abdominal static and dynamic pain scores than the other groups till 18 hours postoperatively (P<0.001). In addition, group II had statistically significant lower abdominal static and dynamic pain scores than group III in the most of assessment points (P<0.05). The time for first required analgesics was significantly longer in group I (336.2±67.54 minutes) than other groups (P<0.001). The proportion of patients who required two or more doses of ketorolac was significantly lower in group I than other groups (P<0.001). The proportion of patients with nausea or vomiting was not significantly different across study’s groups (P>0.05).
CONCLUSIONS: Intraperitoneal bupivacaine-magnesium combination provides better analgesia and reduces postoperative morphine consumption than bupivacaine-hydrocortisone or magnesium-hydrocortisone combinations after laparoscopic ovarian cystectomy.
(Cite this article as: Gaballah KM, Habeeb RM, Abdallah SI. Efficacy of intraperitoneal bupivacaine, hydrocortisone, and magnesium sulfate in different combinations for pain relief after laparoscopic ovarian cystectomy: a double-blind randomized controlled trial. Minerva Anestesiol 2020;86:14-22. DOI: 10.23736/S0375-9393.19.13550-X)
Key words: Cystectomy; Intraperitoneal injections; Bupivacaine; Postoperative pain; Hydrocortisone; Magnesium sulfate.