【摘要】 目的 比較利多卡因不同劑量預(yù)處理對羅庫溴銨注射痛的影響。 方法 120例行全身麻醉擇期手術(shù)的患者按照完全隨機的方法分為利多卡因10 mg 3 mL預(yù)處理組（A組），利多卡因25 mg 3 mL預(yù)處理組（B組），利多卡因50 mg 3 mL預(yù)處理組（C組），生理鹽水3 mL預(yù)處理組（D組）。觀察不同劑量的利多卡因預(yù)處理對羅庫溴銨注射痛的影響。 結(jié)果 A、B、C和D組注射羅庫溴銨的疼痛發(fā)生率分別為53%、27%、3%和90%。與生理鹽水預(yù)處理組相比，利多卡因預(yù)處理組能明顯減輕羅庫溴銨引起的注射痛（Plt;0.01）；劑量越大，效果越明顯。 結(jié)論 利多卡因10、25、50 mg預(yù)處理均能顯著降低羅庫溴銨注射時引起的疼痛，以50 mg利多卡因更為有效。【Abstract】 Objective To compare the effects of different doses of lidocaine pretreatment on the pain from injection with rocuronium. Methods One hundred and twenty patients of general anesthesia had undergone elective surgery, were randomly divided into lidocaine 10 mg 3 mL pretreated group (group A), lidocaine 25 mg 3 mL pretreated group (group B), lidocaine 50 mg 3 mL pretreated group (group C) and saline 3 mL pretreated group (group D). The effects of different doses of lidocaine pretreatment on injection pain of rocuronium were observed. Results The pain incidence from injection with rocuronium in A, B, C, D groups were 53%, 27%, 3% and 90% respectively. The higher dose of lidocaine, the more obvious effect. Conclusion Lidocaine pretreatment with 10, 25, 50 mg can reduce the severity of pain from injection with rocuronium, and lidocaine 50 mg is the most effective.
【摘要】 目的 評估羅哌卡因切口預(yù)注射聯(lián)合曲馬多對腹腔鏡下膽囊切除術(shù)（laparoscopic cholecystectomy，LC）術(shù)后疼痛的影響?！》椒ā∵x取2010年6月-2011年4月行擇期LC患者120例，年齡18~65歲，美國麻醉師協(xié)會Ⅰ~Ⅱ級，采用完全隨機的設(shè)計分組：0.75%羅哌卡因10 mL切口注射+術(shù)畢靜脈注射曲馬多（2 mg/kg）組（A組，n=30）；生理鹽水10 mL切口注射+術(shù)畢靜脈注射曲馬多（2 mg/kg）組（B組，n=30）；0.75%羅哌卡因10 mL切口注射+術(shù)畢靜脈注射生理鹽水10 mL組（C組，n=30）；生理鹽水組（D組，n=30）。術(shù)后2、4、6、12、24 h分別評估右上腹部、右肩背部和腹壁切口疼痛進行視覺模擬評分（visual analog scale，VAS）?！〗Y(jié)果 右上腹部及右肩背部疼痛VAS比較：與D組相比，A、B組VAS評分明顯減少（Plt;0.05），而C組無明顯統(tǒng)計學(xué)差異（Pgt;0.05）；B組與A組相比，2~24 h VAS評分明顯增加（Plt;0.05）；C組與A組相比，2~24 h VAS評分增高（Plt;0.01）。腹壁切口疼痛VAS比較:與D組相比，A、B、C組VAS評分明顯減少（Plt;0.05）；B組與A組相比，2~24 h VAS評分明顯增加（Plt;0.05）；C組與A組相比，2~24 h VAS評分顯著增高（Plt;0.01）?！〗Y(jié)論 腹腔鏡膽囊切除術(shù)術(shù)前切口羅哌卡因預(yù)注射-術(shù)畢曲馬多靜脈注射對減輕術(shù)后疼痛有良好效果?！続bstract】 Objective To evaluate the effects of preincisional ropivacaine plus tramadol intravenous injection on postoperative pain relief after laparoscopic cholecystectomy (LC). Methods One hundred and twenty patients aged between 18 and 65 years old with an ASA score from Ⅰ to Ⅱ who underwent elective laparoscopic cholecystectomy from June 2010 to April 2011 comprised this study. The patients were randomly divided into four groups with 30 in each group. Patients in group A had an infusion of 0.75% ropivacaine (10 mL) at the beginning of LC plus tramadol (2 mg/kg) intravenous injection at the end. Group B patients had an infusion of normal saline 0.9% (10 mL) at the beginning of LC plus tramadol (2 mg/kg) intravenous injection at the end. Patients in group C had an infusion of 0.75% ropivacaine (10 mL) at the beginning of LC plus normal saline 0.9% (10 mL) intravenous injection at the end. Group D (control group) patients had neither ropivacaine nor tramadol infusion. Pain in the right upper abdomen, right shoulder tip and abdominal incision were assessed at hour 2, 4, 6, 12, and 24 postoperatively using a visual analog score (VAS). Results Right upper abdomen and right shoulder tip pain VAS comparison: significantly lower pain scores were observed in group A and B (Plt;0.05) than in group D (Pgt;0.05). Group A had significantly lower pain scores than group B (Plt;0.05) and C (Plt;0.01) at postoperative hours 2, 4, 6, 12, and 24. Abdominal incision pain VAS comparison: VAS scores were significantly lower in group A, B and C than in group D (Plt;0.05). Group A had significantly lower pain scores than group B (Plt;0.05) and C (Plt;0.01) at postoperative hours 2, 4, 6, 12, and 24. Conclusion Preincisional ropivacaine at the beginning of LC combined with tramadol intravenous injection at the end can effectively alleviate postoperative pain after laparoscopic cholecystectomy.