Application Study On Fast-tracking Anesthesia With Local Infiltration Of Ropivacaine In Laparoscopic Cholecystectomy

【Objective】To evaluate the clinical efficiency of local infiltration around a surgical incision and injection into abdominal cavity of ropivacaine hydrachloride on Fast-track anaesthesia for laparoscopic cholecystectomy.【Methods】six ty patients scheduled for elective LC were randomized in two groups with 30 patients each:total intravenous anesthesia group(TIVA) and TIVA in combination with local infiltration and abdominal cavity injection of ropivacaine group(TIVAR).All patients were induced and maintained with TCI propofol-remifentanil which was stopped before abdominal incision was sutured.The patients in group TIVAR were given 0.75%roprivacaine hydrochloride 30ml to four incision before operation and 0.25%roprivacaine hydrochloride 30ml to the surface of gallbladder bed and hypatic diaphragm interpace before perforation equipment were furgged out.The following were recorded and compared between the 2 groups:(1)the changes in MAP and HR during induction,tracheal intubation,operation and extubation;(2)the time from the terrmination of anaesthesia to recovery spontaneous breathing,eye opening at request,orientation and extubation after termination of anaesthesia;(3)the time from discontinuation of the maintenance anesthetics to fast-track eligibility using the new scoring systems(4)the total administrated dose of propofol(mg.kg^-1.h^-1 ) and remifentanil(μg.kg^-1.h^-1) druing anesthesia.【Results】(1)The duration from termination of anesthetics to fully recovery of spontaneous breathing,eye opening at request,orientation and tracheal extubation were similar between the two groups.(2)The time from discontinuation of the maintenance anesthetics to fast-track eligibility was significantly shorter in group TIVAR than that in group TIVA.(3)The total administrated dose of anesthetics including propofol and remifentanil was significantly lower in group TIVAR than that in group TIVA.【Conclusions】Fast-tracking anesthesia with preincisional local infiltration and abdominal cavity infusion of roprivacaine hydrochloride in laparoscopic cholecystectomy is effective and safe,which can lessen intro-and postoperative anesthetics requirements and facilitate fast-track recovery after LC especially facilitate postanesthesia care unit bypass.