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目的:观察术中静脉应用大剂量维生素C (vitamin C, Vit C）对腹腔镜全子宫切除术后急性疼痛及早期康复的影响，并在炎症因子水平探讨其可能机制。方法:初筛择期行腹腔镜全子宫切除术患者165例，根据纳排标准共入组92例，按随机数字表法分为试验组（n n=46）和对照组（n n=46）。试验组自麻醉诱导后持续静脉泵注Vit C注射液（20 mg·kgn -1·hn -1）至术毕，对照组以生理盐水同等速度静脉泵注至术毕；两组患者麻醉方法相同，术后均予患者自控静脉镇痛。记录两组患者术后4、8、12、24、48 h非切口痛（nonsurgical wound pain, NWP）发生率，静息与咳嗽状态下切口痛VAS疼痛评分，术后48 h内舒芬太尼用量、术后不良反应发生情况；测定患者术前和术毕血清IL-6、IL-10、5-羟色胺（5-hydroxytryptamine, 5-HT）浓度；同时记录两组患者首次下床活动时间、首次排气时间、拔尿管时间和术后住院时间。n 结果:试验组术后4、8、12 h和24 h NWP发生率显著低于对照组（n P0.05）；两组患者术后各时间点静息与咳嗽状态下切口痛VAS疼痛评分差异均无统计学意义（n P>0.05）；试验组术后48 h内舒芬太尼用量显著少于对照组（n P0.05）；两组患者术毕血浆IL-6、IL-10、5-HT浓度均较术前升高（n P0.05). The consumption of sufentanil during the first 48 h in the test group was less than that in control group (n P<0.05). There was no statistical difference in adverse reaction incidence between the two groups (n P<0.05). After surgery, the concentrations of plasma IL-6, IL-10 and 5-HT of the two groups were higher than those before surgery (n P<0.05); the increases in the concentrations of IL-6 and 5-HT of the test group were less than those in the control group, while the increase in IL-10 concentration of the test group was more than that in the control group (n P<0.05). The test group showed significantly decreased time of first out-of-bed activity and the time of first anal exhaust, compared with the control group (n P<0.05). There was no statistical difference in the time of first anal exhaust between the two groups (n P0.05).n Conclusions:Intravenous high-dose Vit C can reduce the incidence of NWP after total laparoscopic hysterectomy, reduce postoperative analgesic consumption and promote early recovery. Inhibition of excessive inflammatory reactions and decrease of 5-HT concentrations may be one of analgesic mechanism.