摘要
目的探讨腹腔镜引导下双侧子宫骶韧带区域神经阻滞对腹腔镜下子宫肌瘤剔除手术患者术后镇痛及早期康复的影响。方法将择期全麻下行腹腔镜子宫肌瘤剔除术的患者70例随机分为观察组和对照组,每组35例。观察组全麻复合双侧子宫骶韧带区域神经阻滞后开始手术,对照组单纯全麻后开始手术。记录术中麻醉药物用量、术后不同时间点的VAS疼痛评分、术后肠道功能恢复时间、下床活动时间、术后24 h的15项恢复质量(quality of recovery,QoR⁃15)评分。记录术后镇痛药物使用总量、镇痛补救率及相关不良反应的发生情况。结果与对照组比较,观察组患者术中瑞芬太尼用量减少(P<0.05),术后2 h疼痛评分明显降低(P<0.05),术后24 h的QoR⁃15评分明显升高(P<0.05),术后24 h内镇痛药用量、镇痛补救率、头晕、恶心呕吐发生率明显降低(P<0.05)。结论腹腔镜引导下双侧子宫骶韧带区域神经阻滞可降低腹腔镜子宫肌瘤剔除手术患者围术期阿片类药物的使用量,减轻患者术后疼痛,降低术后相关并发症,提高患者的恢复质量。
Objective To investigate the effect of laparoscopic guided regional nerve block of bilateral uterosacral ligaments on postoperative analgesia and early rehabilitation of patients undergoing laparoscopic myo⁃mectomy.Methods 70 patients scheduled for elective laparoscopic myomectomy under general anesthesia were randomly divided into two groups with 35 patients in each group.The observation group performed after general an⁃esthesia combined with nerve block in bilateral uterosacral ligament region,andthe control group performed after general anesthesia.The amount of anesthetic used during the operation,the VAS pain score at different time points after the operation,the recovery time of intestinal function after the operation,the time of immobility,and the 15 quality of recovery(QoR⁃15)scores 24 hours after the operation were recorded.The total amount of analgesics used,the recovery rate of analgesia and the occurrence of related adverse reactions were recorded.Results Com⁃pared with control group,the intraoperative consumption of remifentanil was significantly reduced(P<0.05),and the VAS pain score of 2 hours after operation in the observation group was lower(P<0.05).The QoR⁃15 score at 24 hours after the operation were significantly increased(P<0.05),and the analgesic dosage,analgesic salvage rate,and the incidence of nausea and vomiting were significantly reduced in the observation group within 24 hours after surgery(P<0.05).Conclusion Laparoscopic guided regional nerve block of bilateral uterosacral ligaments can reduce the perioperative opioid dosage of patients with laparoscopic myomectomy,reduce postoperative pain,re⁃duce postoperative complications,and improve the quality of postoperative recovery.
作者
汪海金
王克功
龚廷
刘颖
张振
罗辉宇
WANG Haijin;WANG Kegong;GONG Ting;LIU Ying;ZHANG Zhen;LUO Huiyu(Department of Anesthesiology,Xiangyang No.1 People′s Hospital,Hubei University of Medicine,Xiangyang 441000,China)
出处
《实用医学杂志》
CAS
北大核心
2023年第9期1127-1131,共5页
The Journal of Practical Medicine
基金
湖北省教育厅科学研究计划指导性项目(编号:B2022126)。
关键词
子宫骶韧带区域神经阻滞
腹腔镜子宫肌瘤剔除术
术后镇痛
早期康复
regional block of uterosacral ligament
laparoscopic myomectomy
postoperative analge⁃sia
early rehabilitation
