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首页> 外文期刊>Surgical Endoscopy >Preinsertion local anesthesia at the trocar site improves perioperative pain and decreases costs of laparoscopic cholecystectomy.
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Preinsertion local anesthesia at the trocar site improves perioperative pain and decreases costs of laparoscopic cholecystectomy.

机译：套管针部位的预插入局部麻醉可改善围手术期疼痛并降低腹腔镜胆囊切除术的费用。

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BACKGROUND: Local anesthesia at the trocar site in laparoscopic cholecystectomy is expected to decrease postoperative pain and hence expedite recovery. The aims of this prospective randomized study were to investigate the effect of local anesthesia and to discover whether it is cost effective. METHODS: For this study, 100 patients undergoing laparoscopic cholecystectomy were randomized into two groups. The 43 study patients were injected with 0.5% bupivacaine hydrochloride at the trocar site before the trocars were inserted. They then were compared with 41 control patients who received no local anesthesia. The remaining 16 patients were excluded from the study. The postoperative pain was evaluated at the standard four trocar sites at 4 h and 24 h after surgery on a scale 1 (the mildest pain the patient had ever experienced) to 10 (the most severe pain the patient had ever experienced). Postoperative pain medications and their cost were evaluated. RESULTS: There was no difference between the two groups with regard to gender, age, weight, operative time, estimated operative blood loss, and bile culture. The patients who received bupivacaine at the trocar site clinically had less pain (p < 0.001 for all four sites) both at 4 and 24 h after surgery. The treatment group patients used less mepiridine and promethzine than the control group (p = 0.001 and 0.002, respectively) postoperatively. Overall, the patients who had local anesthesia used less postoperative pain and antiemetic medication than the control patients (p = 0.02). This afforded a significant decrease in the costs and charges of these medications (p = 0.004 and 0.005, respectively). Three patients in the study group were discharged from the hospital the day of surgery. Conclusion: Preinsertion of local anesthesia at the trocar site in laparoscopic cholecystectomy significantly reduces postoperative pain and decreases medication usage costs.
机译：背景：腹腔镜胆囊切除术中套管针部位的局部麻醉有望减轻术后疼痛，从而加快恢复速度。这项前瞻性随机研究的目的是调查局部麻醉的效果并发现其是否具有成本效益。方法：本研究将100例行腹腔镜胆囊切除术的患者随机分为两组。在插入套管针之前，这43名研究患者在套管针部位注射了0.5％的布比卡因盐酸盐。然后将他们与41例未接受局部麻醉的对照患者进行比较。其余16名患者被排除在研究之外。术后4小时和24小时，在标准的四个套管针部位评估术后疼痛，评分范围为1（患者曾经历过的最轻的疼痛）至10（患者经历过的最严重的疼痛）。评估了术后止痛药及其费用。结果：两组在性别，年龄，体重，手术时间，估计的手术失血量和胆汁培养方面无差异。临床上在套管针部位接受布比卡因的患者在手术后4小时和24小时内疼痛减轻（所有四个部位的p <0.001）。与对照组相比，治疗组患者术后甲吡丙啶和异丙嗪的使用量更少（分别为0.001和0.002）。总体而言，局部麻醉的患者术后疼痛和止吐药物的使用率低于对照组（p = 0.02）。这大大降低了这些药物的成本和收费（分别为p = 0.004和0.005）。研究组中的三名患者在手术当天从医院出院。结论：在腹腔镜胆囊切除术中，在套管针部位预先插入局部麻醉可显着减少术后疼痛并降低用药成本。

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