首页|肺癌术后胸膜腔不同浓度利多卡因浸润镇痛对患者康复的影响

肺癌术后胸膜腔不同浓度利多卡因浸润镇痛对患者康复的影响

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目的 探讨肺癌术后胸膜腔不同浓度利多卡因浸润镇痛对患者康复的影响.方法 选取我院收治的86例肺癌患者,按照随机数字表法分为高浓度组(43例)与低浓度组(43例).高浓度组患者在术后第1天经硬膜外导管于胸膜腔内注入2.0%盐酸利多卡因,低浓度组患者于胸膜腔内注入1.5%盐酸利多卡因,2组患者术后均采取静脉自控镇痛.比较2组患者术后首次下床活动时间、首次排气时间、首次排便时间、住院时间,并比较术后6 h、12 h、24 h、48 h视觉模拟量表(VAS)评分,术后苏醒期躁动发生情况和术后24 h内镇痛泵按压次数、镇痛药物用量.术后24 h,记录2组患者药物不良反应发生情况,采用40项恢复质量评分量表(QoR-40)评估患者恢复质量.结果 高浓度组患者术后首次下床活动时间、首次排气时间、首次排便时间、住院时间均短于低浓度组(P<0.05).2组患者术后12 h、24 h时VAS评分均高于术后6 h(P<0.05),术后24 h、48 h时VAS评分低于术后12 h(P<0.05),术后48 h时VAS评分均低于术后24 h(P<0.05);高浓度组患者术后6 h、12 h、24 h、48 h时VAS评分均低于低浓度组(P<0.05).高浓度组患者苏醒期躁动发生率和术后24 h内镇痛泵按压次数、镇痛药物用量均低/少于低浓度组(P<0.05).2组患者术后药物不良反应总发生率比较,差异无统计学意义(P>0.05).高浓度组患者QoR-40总分高于低浓度组(P<0.05).结论 肺癌患者术后采用2.0%利多卡因胸膜腔浸润镇痛可减少患者苏醒期躁动,减轻术后疼痛,提高术后恢复质量,促进患者术后康复,且具有一定的安全性.
Effects of different concentrations of lidocaine infiltration and analgesia in pleural cavity after lung cancer surgery on rehabilitation of patients
Objective To explore the effects of different concentrations of lidocaine infiltration and analgesia in pleural cavity after lung cancer surgery on rehabilitation of patients.Methods A total of 86 patients with lung cancer were selected and divided into the high concentration group(43 cases)and low concentration group(43 cases)by random number table method.Patients in the high concentration group received injection of 2.0%lidocaine hydrochloride in pleural cavity through the epidural catheter 1st day after surgery,and patients in the low concentration group received injection of 1.5%lidocaine hydrochloride in pleural cavity.In addition,patients in the two groups were treated with patient-controlled intravenous analgesia after surgery.The first time of getting out of bed,first time of exhaustion,first time of defecation and hospital stay after surgery of the two groups were compared.The visual analogue scale(VAS)scores 6 hours,12 hours,24 hours and 48 hours after surgery,the occurrence of agitation during the postoperative awakening period,and the number of analgesic pump compressions and the dosage of analgesic drugs within 24 hours after surgery were compared.The incidence of adverse drug reactions 24 hours after surgery were recorded and the quality of recovery of patients 24 hours after surgery was evaluated by 40-item quality of recovery score(QoR-40).Results The first time of getting out of bed,first time of exhaustion,first time of defecation and hospital stay after operation of patients in the high concentration group were shorter than those in the low concentration group(P<0.05).The VAS scores of the two groups 12 hours and 24 hours after surgery were higher than those 6 hours after surgery(P<0.05),the VAS scores 24 hours and 48 hours after surgery were lower than those 12 hours after surgery(P<0.05),and the VAS scores 48 hours after surgery were lower than those 24 hours after surgery(P<0.05).The VAS scores 6 hours,12 hours,24 hours,and 48 hours after surgery of patients in the high concentration group were lower than those in the low concentration group(P<0.05).The occurrence of agitation during the postoperative awakening period,and the number of analgesic pump compressions and the dosage of analgesic drugs within 24 hours after surgery for patients in the high concentration group were lower/less than those in the low concentration group(P<0.05).There was no significant difference in the total incidence of adverse drug reactions between the two groups(P>0.05).The total QoR-40 score of patients in the high concentration group were higher than those in the low concentration group(P<0.05).Conclusion The use of 2.0%lidocaine infiltration and analgesia in pleural cavity for patients after lung cancer surgery can reduce the agitation during the awakening period,alleviate the postoperative pain,improve the quality of postoperative recovery,and promote the postoperative recovery of the patients,with certain safety.

lung cancerlidocainepleural cavityinfiltration anesthesiarecovery

李成林、鲜正睿、张乐、梁静、刘曙、邱容

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武警四川省总队医院胸外科,四川 乐山 614000

肺癌 利多卡因 胸膜腔 浸润麻醉 康复

2024

局解手术学杂志
重庆市解剖学会,第三军医大学

局解手术学杂志

CSTPCD
影响因子:1.063
ISSN:1672-5042
年,卷(期):2024.33(1)
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