【摘要】：目的評(píng)價(jià)腫脹麻醉技術(shù)在腹股溝疝腹膜前間隙修補(bǔ)手術(shù)的療效及安全性。方法回顧性分析本院2012年1月至2016年3月診斷為腹股溝疝患者的臨床資料。根據(jù)病例資料術(shù)中麻醉方法不同分為兩組,采用0.5%利多卡因的常規(guī)局部麻醉(LA組)和采用腫脹麻醉(TLA組),均使用強(qiáng)生公司疝修補(bǔ)裝置(ultrapro hernia system,UHS)補(bǔ)片行腹膜前間隙修補(bǔ)完成手術(shù)。以手術(shù)時(shí)間、術(shù)中利多卡因的使用劑量、術(shù)后鎮(zhèn)痛效果持續(xù)時(shí)間、術(shù)后3 d疼痛消失例數(shù)、術(shù)后1 d止痛藥使用例數(shù)、術(shù)后7 d疼痛發(fā)生例數(shù),以及術(shù)后并發(fā)癥發(fā)生率作安全性指標(biāo)。結(jié)果共篩選出86例術(shù)中采用常規(guī)局部麻醉的臨床資料,98例術(shù)中采用腫脹麻醉的臨床資料。兩組的一般資料比較差異無統(tǒng)計(jì)學(xué)意義(P0.05)。兩組均順利完成手術(shù),未出現(xiàn)局麻中毒反應(yīng),術(shù)中均未更改麻醉方法。TLA組利多卡因使用量和手術(shù)時(shí)間明顯低于LA組[(140±8)mg vs(278±9)mg;(41±7)min vs(48±7)min,P0.01],術(shù)后鎮(zhèn)痛持續(xù)時(shí)間長(zhǎng)于LA組[(4.2±0.8)h vs(1.2±0.3)h,P0.01],TLA組術(shù)后1 d使用鎮(zhèn)痛藥物的比例低于LA組(P0.01),兩組術(shù)后3 d疼痛消失例數(shù)、持續(xù)性疼痛發(fā)生率,術(shù)后并發(fā)癥發(fā)生率差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論腫脹麻醉在腹股溝疝腹膜前修補(bǔ)術(shù)中縮短了手術(shù)時(shí)間,減少了利多卡因用量,有良好的術(shù)中麻醉鎮(zhèn)痛效果以及安全性,術(shù)后鎮(zhèn)痛持續(xù)時(shí)間優(yōu)于常規(guī)局部麻醉。
[Abstract]:Objective to evaluate the efficacy and safety of swelling anesthesia in the repair of preperitoneal space of inguinal hernia. Methods the clinical data of patients with inguinal hernia from January 2012 to March 2016 were retrospectively analyzed. According to the intraoperative anesthetic methods, the patients were divided into two groups: 0.5% lidocaine conventional local anesthesia (LA group) and swelling anesthesia (TLA group). Johnson company hernia repair device (ultrapro hernia system UHS patch was used to complete the operation of anterior peritoneal space repair. The time of operation, the dosage of lidocaine during operation, the duration of postoperative analgesia, the number of cases of pain disappearing at 3 days after operation, the number of cases using painkillers 1 day after operation, and the number of cases of pain occurring 7 days after operation were analyzed. And the incidence of postoperative complications as a safety index. Results A total of 86 cases were selected for routine local anesthesia. 98 cases were treated with swelling anesthesia. There was no significant difference in general data between the two groups (P0.05). The operation was completed successfully in both groups, and no local anesthetic poisoning was found in the two groups. No changes in anesthetic methods. The dosage and operation time of lidocaine in TLA group were significantly lower than those in LA group [(140 鹵8) mg vs (, 278 鹵9) mg; (, 41 鹵7) min vs (, 48 鹵7 min, P0.01)]. The duration of postoperative analgesia was longer than that in LA group [(4.2 鹵0.8) h vs (, 1.2 鹵0.3) hu, P0.01] the proportion of analgesic drugs used in TLA group was lower than that in LA group on the first day after operation (P0.01), and the postoperative analgesic duration in both groups was lower than that in LA group (P0.01). 3 days pain disappeared, There was no significant difference in the incidence of persistent pain and postoperative complications (P0.05). Conclusion swelling anesthesia can shorten the operation time and reduce the dosage of lidocaine in preperitoneal repair of inguinal hernia. It has good analgesic effect and safety during operation and the duration of postoperative analgesia is better than that of routine local anesthesia.
【作者單位】： 宜賓市第二人民醫(yī)院胃腸疝外科;宜賓市第二人民醫(yī)院麻醉科;
【基金】：宜賓市衛(wèi)計(jì)委項(xiàng)目(201025)~~
【分類號(hào)】：R614

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