应用罗哌卡因对腹腔镜胆囊切除术后疼痛效应观察

探讨在腹腔镜胆囊切除术术前应用罗哌卡因切口浸润结合术中腹腔喷洒对术后疼痛的缓解效应.将80例患者随机分为四组（各20例）.试验A组：应用0.5％的罗哌卡因20ml进行胆囊床喷洒；试验B组：应用0.5％的罗哌卡因10ml进行胆囊床喷洒,同时10ml进行膈下喷洒；对照A组：采用生理盐水20ml进行胆囊床注射；对照B组：采用生理盐水10ml进行胆囊床注射,同时10ml进行膈下喷洒.对术后疼痛情况进行评价.试验A、B组术后1h、4h、8h腹腔内疼痛、切口疼痛及咳嗽时疼痛VAS评分与对照A、B组相比差异有统计学意义（P＜0.05）；试验B组1h、4h、8h、24h、48h肩部疼痛VAS评分与对照B组相比差异有统计学意义（P＜0.05）,试验A组1h、4h、8h、24h、48 h肩部疼痛VAS评分比试验B组相比明显高,差异有统计学意义（P＜0.05）.腹腔镜胆囊切除术术前应用罗哌卡因切口浸润结合术中腹腔喷洒,可有效减轻患者疼痛,对于促进康复具有积极作用.

Effect Observation of Ropivacaine Application on Laparoscopic Cholecystectomy for Postoperative Pain Relief

To discusses the effect of preoperative ropivacaine application of laparoscopic cholecystectomy combined with surgery incision infiltration in combination with intraoperative peritoneal spraying for postoperative pain relief, 80 cases were randomly divided into four groups （each 20 cases）. Group A： 20ml of 0.5% of ropivacaine was for gallbladder bed spray infiltration; Group B： 0.5% of ropivacaine 10ml was for gallbladder bed spray infiltration, at the same time with 10ml diaphragmatic spraying~ Control group A： using normal saline 20ml to gallbladder bed injection; Control group B： using 10ml of normal saline injection for the gallbladder bed, at the same time with 10ml spray under the diaphragm. The postoperative pain was evaluated. VAS scores of lh, 4h, 8h incision pain, abdominal pain and coughing pain in Group A and Group B differed significantly from Control group A and group B （P〈0.05） ; VAS scores of lh, 4h, 8h, 24h and 48h shoulder pain in Group B differed significantly from control group B （P〈0.05） ; VAS scores of lh, 4h, 8h, 24h and 48h shoulder pain in Group A were significantly higher than Group B （P 〈 0. 05）. Preoperative ropivacaine application of laparoscopic cholecystectomy combined with surgery incision infiltration in combination with intraoperative peritoneal spraying, can effectively relieve patients＂ pain, and plays a positive role in promoting rehabilitation.