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首页> 外文期刊>Surgical Endoscopy >Effect of local anesthetics on postoperative pain and opioid consumption in laparoscopic colorectal surgery
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Effect of local anesthetics on postoperative pain and opioid consumption in laparoscopic colorectal surgery

机译：局部麻醉对腹腔镜大肠癌手术后疼痛和阿片类药物消耗的影响

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Background Several studies have evaluated use of local anesthetic, specifically, administration of intraperitoneal anesthetic, during laparoscopic general surgery and gynecologic operations, with varying results. There have been no studies to determine the role of local anesthetic in laparoscopic colorectal surgery. This study evaluates the efficacy of subcutaneous and intraperitoneal anesthetic in reducing postoperative pain following common laparoscopic colorectal procedures, in patients managed with enhanced recovery care pathways. Methods A single-institution retrospective cohort analysis of 172 patients who underwent common elective laparoscopic colorectal procedures was carried out. Over three consecutive time periods, patients were divided into three study arms, based on administration of local anesthetic. The first group received no local anesthetic (n = 66), the next received only subcutaneous bupivacaine (n = 67), and the final group received both subcutaneous bupivacaine and intraperitoneal lidocaine (n = 44). Pain scores, time in the postoperative care unit, and the amount of opioid pain medication consumed in the immediate postoperative period were quantified. Results There was no difference in pain scores reported between the three study arms, including upon arrival and upon leaving the recovery unit (P B 0.086, P B 0.166), and at 3, 6, 9, and 12 h postoperatively (P B 0.332, P B 0.142, P B 0.155, P B 0.872). There was no significant difference in the amount of postoperative opioid analgesia consumed between the three study arms on postoperative day 0 and on postoperative day 1 (P B 0.365, P B 0.458). There were no significant differences in the amount of time spent in the postoperative care unit, hospital stay, 30 day morbidity, or 30 day mortality between the three study arms. Conclusions Use of local anesthetic does not influence postoperative opioid requirements or patients' subjective report of pain following laparoscopic colorectal procedures managed within enhanced recovery care pathways.
机译：背景几项研究评估了腹腔镜普通外科手术和妇科手术中局部麻醉药的使用，特别是腹膜内麻醉的使用，结果各不相同。尚无研究确定局麻药在腹腔镜结直肠手术中的作用。这项研究评估了在常规腹腔镜结直肠癌手术后皮下和腹膜内麻醉剂减轻术后疼痛的功效，这些患者的康复护理途径得到了加强。方法对172例行常规择期腹腔镜结直肠手术的患者进行单机构回顾性分析。在连续三个时间段内，根据局部麻醉剂的使用情况，将患者分为三个研究组。第一组未接受局部麻醉（n = 66），第二组仅接受了皮下布比卡因（n = 67），最后一组接受了皮下布比卡因和腹膜内利多卡因（n = 44）。量化疼痛评分，术后护理时间和术后即刻服用的阿片类止痛药的量。结果三个研究组之间的疼痛评分没有差异，包括到达和离开恢复单元时（PB 0.086，PB 0.166），以及术后3、6、9和12小时（PB 0.332，PB 0.142）。 ，PB 0.155，PB 0.872）。在术后第0天和术后第1天，三个研究组之间服用的阿片类镇痛镇痛剂的量没有显着差异（P B 0.365，P B 0.458）。三个研究组之间的术后护理时间，住院时间，30天发病率或30天死亡率没有显着差异。结论局部麻醉药的使用不会影响术后阿片类药物的需求或患者在增强的康复护理途径下进行腹腔镜结直肠癌手术后的疼痛主观报告。

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