Laparoscopy is frequently associated with postoperative shoulder pain that may last several days. We have assessed the analgesic effect of intraperitoneal local anaesthetics during day-case diagnostic laparoscopy. 80 young women were randomly assigned to one of four groups of 20 patients each: group 1, no peritoneal administration; group 2, 80 ml saline injected under direct vision in the right subdiaphragmatic area at the start of the procedure; group 3, 80 ml 0.5% lignocaine with adrenaline (320,000 dilution); group 4, 0.125% bupivacaine with adrenaline (800,000 dilution). Scapular pain was assessed with a visual analogue pain scale, and information about nausea, vomiting, abdominal pain, and analgesic requirements during the first 48 h was sought. Both local anaesthetics were more effective in reducing postoperative shoulder pain than either control or saline. Analgesic requirements were greater in the non-treatment groups than in the local anaesthetic groups. Intraperitoneal local anaesthetic administration during laparoscopy is both a non-invasive and an efficient method of reducing the intensity of scapular pain.

译文

腹腔镜检查通常与可能持续数天的术后肩部疼痛有关。我们在日间诊断性腹腔镜检查中评估了腹膜内局部麻醉剂的镇痛作用。80名年轻女性被随机分配到四组中的一组,每组20名患者: 第1组,不腹膜给药; 第2组,在手术开始时在右侧膈下区域直视下注射80毫升生理盐水; 第3组,用肾上腺素 (320,000稀释) 80毫升0.5% 利多卡因; 第4组,0.125% 布比卡因与肾上腺素 (800,000稀释)。用视觉模拟疼痛量表评估肩cap骨疼痛,并寻求有关头48小时内恶心,呕吐,腹痛和镇痛需求的信息。与对照组或生理盐水相比,两种局部麻醉剂在减轻术后肩部疼痛方面都更有效。非治疗组的镇痛需求高于局部麻醉组。腹腔镜检查过程中腹膜内局部麻醉给药既是一种非侵入性的,也是减轻肩胛骨疼痛强度的有效方法。

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