Pain degree of three different incisions and relationship between incisions local infiltration and nausea-vomiting in patients receiving LC / 中国内镜杂志

ABSTRACT

Objective To discuss the pain degree of the three different incisions (subxiphoid, navel, right abdomen) and the relationship between incisions local infiltration and nausea-vomiting after Laparoscopic Cholecystectomy (LC). Methods 100 patients (ASA I) scheduled for elective surgery were randomly divided into 5 groups (n = 20) Subxiphoid Group (Group A), Navel Group (Group B), Right Abdomen Group (Group C), All Incisions Group (Group D) and Control Group (Group E). Before the incisions were sutured, patients in Group A, Group B and Group C received incisions local infiltration of Ropivacaine (0.5％, 3 ml) in subxiphoid, navel and right abdomen. Patients in Group D received incisions local infiltration of Ropivacaine (0.5％, 3 ml) in all the three incisions. Patients in Group E received saline with the same volume (3 ml) in all the three incisions. The Visual Analogue Scale (VAS) pain scores were recorded when the patients left the operating room, 2 hours, 4 hours, 8 hours, 16 hours and 24 hours after the operation. The circumstances of nausea-vomiting were also recorded. Results Demographic parameters were similar among groups. The VAS pain scores declined with time gone by. The VAS pain scoresGroup A< Group D < Group C < Group B < Group E (F = 7.16, P = 0.000). Comparison between groups The VAS pain scores in Group A and Group D were significantly less than these in Group C and Group B. The VAS pain scores in Group C and Group B were significantly less than these in Group E. There is a difference among all the groups about the percentages of nausea-vomiting. The percentages of Group B were significantly less than these in the other 4 Groups (χ2 = 10.39, P = 0.034). Conclusions The pain of the subxiphoid incision was the most severe pain in the patients receiving LC. Compared with the other two incisions local infiltration, subxiphoid incision local infiltration proved to be the most effective treatment in reducing the VAS pain scores in patient receiving LC. Navel incision local infiltration proved to be the most effective treatment in reducing the percentages of nausea-vomiting after LC.