|本期目录/Table of Contents|

[1]蔡锦全,陈书尚,朱凌峰,等.罗哌卡因局部浸润缓解经皮肾镜取石术后疼痛的前瞻性研究[J].医学研究与战创伤救治(原医学研究生学报),2015,17(04):365-367.[doi:10.3969/j.issn.1672-271X.2015.04.009]
　CAI Jin-quan,CHEN Shu-shang,ZHU Ling-feng,et al.Alleviating postoperative pain in patients with percutaneous nephrolithotomy by using local anesthetic infiltration of ropivacaine[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2015,17(04):365-367.[doi:10.3969/j.issn.1672-271X.2015.04.009]
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罗哌卡因局部浸润缓解经皮肾镜取石术后疼痛的前瞻性研究()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第17卷
期数:
2015年04期
页码:
365-367
栏目:
出版日期:
2015-07-20

文章信息/Info

Title:
Alleviating postoperative pain in patients with percutaneous nephrolithotomy by using local anesthetic infiltration of ropivacaine
作者:
蔡锦全; 陈书尚; 朱凌峰; 吴承耀; 邓 震; 谭建明
350025 福建福州，南京军区福州总医院泌尿外科
Author(s):
CAI Jin-quan;  CHEN Shu-shang;  ZHU Ling-feng;  WU Cheng-yao;  DENG Zhen;  TAN Jian-ming.
Department of Urology， Fuzhou General Hospital of Nanjing Military Command， Fuzhou， Fujian 350025， China
关键词:
罗哌卡因; 经皮肾镜取石术; 造瘘管; 疼痛
Keywords:
ropivacaine;  percutaneous nephrolithotomy;  tube;  pain
分类号:
R692.4
DOI:
10.3969/j.issn.1672-271X.2015.04.009
文献标志码:
A
摘要:
目的 探讨经皮肾穿刺通道周围局部浸润罗哌卡因缓解经皮肾镜取石(percutaneous nephrolithotomy，PCNL)术后疼痛的效果。方法 对接受单通道PCNL治疗的上尿路结石患者60例，随机分为两组，观察组和对照组(各30例)。观察组于PCNL术中留置肾造瘘管后，于经皮肾穿刺通道周围注射0.5%罗哌卡因20 mL，对照组则于相同部位注射等渗盐水20 mL。比较两组患者术后1、3、6、12、24 h的疼痛评分(VAS)，术后哌替啶使用情况及并发症。结果 与对照组相比，观察组患者术后24 h内各相应时点的平均VAS评分均明显降低(P<0.05)，哌替啶用量明显减少［(21.7±13.5)mg vs (39.8±29.4)mg，P<0．05］，首次需要应用哌替啶的时间明显延长［(16.6±9.7) h vs (6.8±4.2) h，P<0.01］，而恶心及呕吐的发生率明显减少(23.3% vs 40.0%，P<0.05)。结论 罗哌卡因经皮肾穿刺通道周围局部浸润可有效缓解PCNL术后的切口疼痛，减少术后镇痛药需要量和相应并发症。
Abstract:
Objective To explore the analgesic efficacy of peritubal local anesthetic infiltration of ropivacaine in alleviating postoperative pain in patients with percutaneous nephrolithotomy (PCNL). Methods A total of 60 patients with upper urinary calculi were included and randomized into the ropivacaine group and the control group (both 30 cases). The patients in the ropivacaine group received a 20 mL infiltration of 0.5% ropivacaine into the Peritubal sites after a nephrostomy tube was inserted during PCNL, while patients in the control group received 20 mL infiltration of saline. After the operation, patients visual analog scale (VAS) pain scores at 1, 3, 6, 12 and 24 hours, the usage of pain relief drugs and complications in the two groups were recorded. Results Compared with the control group, significant lower VAS pain scores at 1, 3, 6, 12, and 24 hours postoperatively (P<0.05 for all), less mean amount of pethidine ［(21.7±13.5)mg vs (39.8±29.4)mg，P<0．05］, longer mean time for the first demand of pethidine ［(16.6±9.7) h vs (6.8±4.2) h，P<0.01］, and a lower rate of nausea and/or emesia (23.3% vs 40.0%, P<0.05) were observed in the experiment group. Conclusion Peritubal local anesthetic infiltration of ropivacaine can effectively alleviate postoperative pain after PCNL, and can reduce the usage of postoperative pain-killer as well as the related complications.

参考文献/References:

［1］Sivalingam S，Cannon ST，Nakada SY，et al.Current practices in percutaneous nephrolithotomy among endourologists［J］.J Endourol，2014，28(5):524-527.
［2］高小峰，陈书尚，周 铁，等.经皮肾镜取石术后不留置肾盂造瘘管的疗效评价［J］.中华泌尿外科杂志，2008，29(10):675-677.
［3］Ugras MY，Toprak HI，Gunen H，et al.Instillation of skin，nephrostomy tract，and renal puncture site with ropivacaine decreases pain and improves ventilatory function after percutaneous nephrolithotomy［J］.J Endourol，2007，21(5):499-503.
［4］鲁可权，许承斌，曹希亮，等.经皮肾镜气压弹道超声联合碎石治疗上尿路结石［J］.东南国防医药，2012，14(2):132-134.
［5］Shah HN，Shah RH，Sodha HS，et al.A randomized control trial evaluating efficacy of nephrostomy tract infiltration with bupivacaine after tubeless percutaneous nephrolithotomy［J］.J Endourol，2012，26(5):478-483.
［6］Jonnavithula N，Pisapati MV，Durga P，et al.Efficacy of peritubal local anesthetic infiltration in alleviating postoperative pain in percutaneous nephrolithotomy［J］.J Endourol，2009，23(5):857-860.
［7］Haleblian GE，Sur RL，Albala DM，et al.Subcutaneous bupivacaine infiltration and postoperative pain perception after percutaneous nephrolithotomy［J］.J Urol，2007，178(3 pt 1):925-928.
［8］Gokten OE，Kilicarslan H，Dogan HS，et al.Efficacy of levobupivacaine infiltration to nephrosthomy tract in combination with intravenous paracetamol on postoperative analgesia in percutaneous nephrolithotomy patients［J］.J Endourol，2011，25(1):35-39.
［9］Kirac M，Tepeler A，Bozkurt OF，et al.The efficacy of bupivacaine infiltration on the nephrostomy tract in tubeless and standard percutaneous nephrolithotomy:a prospective，randomized，multicenter study［J］.Urology，2013，82(3):526-531.
［10］张海山，杜梅青.胸膜腔内注射罗哌卡因用于胸腔镜辅助小切口手术术后镇痛的临床研究［J］.临床麻醉学杂志，2013，29(3):235-237.
［11］朱伟东，曾红文，黄荣辉，等.盐酸罗哌卡因在腹腔镜下腹股沟疝补片修补术后镇痛中的应用［J］.泰山医学院学报，2013，34(3):192-193.
［12］白 英，朱云章，于子红.罗哌卡因局部浸润在脊柱手术术后镇痛中的应用［J］.中国实用医药，2013，8(15):164-165.
［13］鞠英男，崔晓光，席宏杰，等.罗哌卡因局部浸润在小儿咽扁术后镇痛中的作用［J］.哈尔滨医科大学学报，2012，46(4):372-375.

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备注/Memo

备注/Memo:
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更新日期/Last Update: 2015-07-20