肿胀麻醉技术在腹股沟疝腹膜前间隙修补术中应用的回顾性分析

发布时间：2018-08-06 10:01

【摘要】：目的评价肿胀麻醉技术在腹股沟疝腹膜前间隙修补手术的疗效及安全性。方法回顾性分析本院2012年1月至2016年3月诊断为腹股沟疝患者的临床资料。根据病例资料术中麻醉方法不同分为两组,采用0.5%利多卡因的常规局部麻醉(LA组)和采用肿胀麻醉(TLA组),均使用强生公司疝修补装置(ultrapro hernia system,UHS)补片行腹膜前间隙修补完成手术。以手术时间、术中利多卡因的使用剂量、术后镇痛效果持续时间、术后3 d疼痛消失例数、术后1 d止痛药使用例数、术后7 d疼痛发生例数,以及术后并发症发生率作安全性指标。结果共筛选出86例术中采用常规局部麻醉的临床资料,98例术中采用肿胀麻醉的临床资料。两组的一般资料比较差异无统计学意义(P0.05)。两组均顺利完成手术,未出现局麻中毒反应,术中均未更改麻醉方法。TLA组利多卡因使用量和手术时间明显低于LA组[(140±8)mg vs(278±9)mg;(41±7)min vs(48±7)min,P0.01],术后镇痛持续时间长于LA组[(4.2±0.8)h vs(1.2±0.3)h,P0.01],TLA组术后1 d使用镇痛药物的比例低于LA组(P0.01),两组术后3 d疼痛消失例数、持续性疼痛发生率,术后并发症发生率差异均无统计学意义(P0.05)。结论肿胀麻醉在腹股沟疝腹膜前修补术中缩短了手术时间,减少了利多卡因用量,有良好的术中麻醉镇痛效果以及安全性,术后镇痛持续时间优于常规局部麻醉。
[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 卤8) mg vs (, 278 卤9) mg; (, 41 卤7) min vs (, 48 卤7 min, P0.01)]. The duration of postoperative analgesia was longer than that in LA group [(4.2 卤0.8) h vs (, 1.2 卤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.
【作者单位】：宜宾市第二人民医院胃肠疝外科;宜宾市第二人民医院麻醉科;
【基金】：宜宾市卫计委项目(201025)~~
【分类号】：R614

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