摘要
目的:探讨布比卡因脂质体注射与腹横肌平面阻滞(TAPB)治疗机器人辅助腹腔镜下妇科肿瘤手术后疼痛。方法:选取2022年1月—2023年6月咸阳市第一人民医院行机器人辅助腹腔镜下妇科肿瘤手术的80例患者,按随机数表法分为对照组(40例,TAPB)和研究组(40例,布比卡因脂质体注射),比较两组患者围手术期相关指标、术后疼痛及舒芬太尼用量。结果:与对照组比较,研究组下床活动时间、住院时间更短,差异具有统计学意义(P<0.05),研究组额外镇痛率和恶心呕吐率更低,差异具有统计学意义(P<0.05)。与对照组比较,研究组术后4 h、8 h、12 h、24 h静息和咳嗽状态VAS评分更低,差异具有统计学意义(P<0.05)。比较两组术后4 h、8 h舒芬太尼用量,差异无统计学意义(P>0.05),研究组术后12 h、24 h舒芬太尼用量更少,差异具有统计学意义(P<0.05)。结论:相较于TAPB,布比卡因脂质体应用于机器人辅助腹腔镜下妇科肿瘤手术可有效减轻术后疼痛,减少舒芬太尼用量,降低额外镇痛率和恶心、呕吐率,有利于患者快速康复。
Objective:To explore the postoperative pain of robot-assisted laparoscopic gynecological tumor surgery with bupivacaine liposome injection and transversus abdominal muscle plane block(TAPB).Methods:A total of 80 patients who underwent robot-assisted laparoscopic gynecological tumor surgery in the First People’s Hospital of Xianyang from January 2022 to June 2023 were selected and divided into the control group(40 cases,TAPB)and the study group(40 cases,bupivacaine liposome injection)by the random number table method.The perioperative indicators,postoperative pain and the dosage of sufentanil of the two groups were compared.Results:Compared with the control group,the time of getting out of bed and hospitalization was shorter,the analgesia rate,nausea and vomiting rate,and the VAS scores in the postoperative resting and coughing state of the study group were lower,and the differences were statistically significant(P<0.05).The dosage of sufentanil at 4 h and 8 h after surgery was compared between the two groups,and there was no statistical significance(P>0.05).Compared with the control group,the dosage of sufentanil at 12 h and 24 h after surgery in the study group was less,and the difference was statistically significant(P<0.05).Conclusion:Compared with TAPB,the application of liposomal bupivacaine in robot-assisted laparoscopic gynecological tumor surgery could effectively reduce postoperative pain,the dosage of sufentanil,the rate of analgesia,and the rate of nausea and vomiting,which is conducive to rapid recovery of patients.
作者
李晓龙
龙敏洁
张姣
赵晓娟
LI Xiaolong;LONG Minjie;ZHANG Jiao;ZHAO Xiaojuan(Department of Anesthesiology,the First People’s Hospital of Xianyang,Xianyang 712000,China;Department of Anesthesiology,Xianyang Central Hospital,Xianyang 712000,China;Department of Gynecology,the First People’s Hospital of Xianyang,Xianyang 712000,China)
基金
咸阳市重点研发计划项目(S2022-ZDYF-SF-1062)。
关键词
妇科肿瘤
布比卡因脂质体
腹横肌平面阻滞
机器人辅助手术
腹腔镜
疼痛
Gynecological Tumor
Liposomal Bupivacaine
Transversus Abdominis Plane Block
Robot-assisted Surgery
Laparoscopy
Pain
