دانلود رایگان مقاله انگلیسی تاثیر لیدوکائین محل برش و داخل صفاق بر تسکین درد بعد از جراحی لاپروسکوپی زنان - الزویر 2018

abstract

Objective: To evaluate the role of Intraperitoneal and port site use of local anesthetic (Lidocaine HCl) in gynecological laparoscopy for postoperative pain relief. Study design: A prospective randomized controlled study. Setting: Aswan University Hospital-Egypt. Materials and methods: We included patients undergoing laparoscopic surgery in the laparoscopy unit either diagnostic or operative. They were classified into two groups: group A (patients underwent diagnostic laparoscopy) and group B (patients underwent operative laparoscopy). Each group was randomized to two sub groups. subgroup 1 or 2; subgroup 1 (control) which comprised 18 patients who were given routine care for surgery and 50 ml normal saline intraperitoneal washing and subgroup 2 (study), which included 18 patients who were given routine care plus pre- and post-incisional subcutaneous injection of 2% lidocaine HCl (xylocaine) 1 ml at each portal site and 10 ml 2% intraperitoneal lidocaine (200 mg) in 50 ml normal saline. The primary outcome of the study is the difference in mean pain score postoperatively between groups. Results: There was significant reduction of the pain 1, 2, 4 and 8 h post-operatively shown by visual analogue scale pain scores in subgroup B2 compared to subgroup B1 and in subgroup A2 compared to subgroup A1 (P-value = 0.000). There was no significant difference in the incidence of nausea, vomiting, shoulder tip pain between both groups. Also there was no significant difference regards time of resumption of intestinal peristalsis and operation duration between subgroups. Conclusions: This study clearly depicts that incisional and intraperitoneal infiltration of lidocaine is an easy, safe, inexpensive, and noninvasive method that provides good analgesia during the early postoperative period and also provides early recovery from laparoscopic surgery.

Conclusions

Utilization of intraperitoneal and port sites Lidocaine HCl can decrease the post-operative pain scores for women after gynecological laparoscopic surgery. Hence, we advocate its use as a routine procedure for minor gynecologic laparoscopic surgery such as diagnostic laparoscopy or short duration operations as drilling or cystectomy.