超声引导下罗哌卡因腹横筋膜阻滞联合帕瑞昔布钠在腹腔镜胃减容术患者术后镇痛中的应用

Application of ultrasound-guided Ropivacaine for abdominal transverse fascia block combined with Parecoxib Sodium in postoperative analgesia in patients undergoing laparoscopic gastric volume reduction surgery

目的超声引导下罗哌卡因腹横筋膜阻滞联合帕瑞昔布钠在腹腔镜胃减容术患者术后镇痛中的应用。方法选择我院2019年1~8月收治的80例行腹腔镜下胃减容术的患者作为研究对象,按照随机数字表法分为治疗组(40例)和对照组(40例),治疗组采用腹腔镜胃减容术+罗哌卡因腹横筋膜阻滞,对照组采用腹腔镜胃减容术。比较两组患者的视觉模拟量表(VAS)评分、术后使用阿片类药物情况、肛门排气时间(术毕到第一次排气的时间)、住院时间。结果治疗组患者术后1、6 h静息状态VAS评分低于对照组,治疗组患者术后48 h的阿片类药物使用率低于对照组,术后恶心呕吐评分低于对照组,肛门排气时间短于对照组,差异有统计学意义(P<0.05);两组患者术后12、24 h静息状态VAS评分、住院时间比较,差异无统计学意义(P>0.05)。结论超声引导下腹横筋膜阻滞联合帕瑞昔布钠用于腹腔镜胃减容术,可降低患者术后疼痛评分及恶心呕吐评分,减少阿片类药物使用,有利于肠功能恢复。

Objective To investigate the application of ultrasound-guided Ropivacaine for abdominal transverse fascia block combined with Parecoxib Sodium in postoperative analgesia in patients undergoing laparoscopic gastric volume reduction surgery.Methods A total of 80 cases of undergoing laparoscopic gastric volume reduction surgery patients admitted to our hospital from January to August 2019 were selected as the research objects,and were divided into a treatment group(40 cases)and a control group(40 cases)according to random number table method.The treatment group was given laparoscopic gastric volume reduction surgery and Ropivacaine transversal fascia block,and the control group was given laparoscopic gastric volume reduction surgery.The two groups patients were compared in terms of visual analogue scale(VAS),opioid use after surgery,anal exhaust time(the time from the end of the surgery to the first exhaust),and the hospital stays.Results The resting VAS scores of patients in the treatment group were lower than those in the control group at 1 and 6 hours after surgery,the opioid use rate at 48 hours after surgery in the treatment group was lower than that in the control group,and the postoperative nausea and vomiting score were lower than those in the control group,and anal exhaust time was shorter than that in the control group,with statistically significant differences(P<0.05).There were no statistically significant differences in resting VAS scores and hospital stays between the two groups of patients at 12 and 24 hours after surgery(P<0.05).Conclusion Ultrasound-guided abdominal transverse fascia block combined with Parecoxib Sodium for laparoscopic gastric volume reduction surgery can reduce postoperative pain score,postoperative nausea and vomiting score,reduce opioid use,and benefit the recovery of intestinal function.