基于加速康复外科理念的多模式镇痛在经尿道前列腺电切术中的应用

Application of multimodal analgesia based on the concept of accelerated rehabilitation surgery in transurethral resection of prostate

目的探讨基于加速康复外科理念的多模式镇痛在经尿道前列腺电切术中的应用。方法选取2017年1月~2018年12月四川省内江市第二人民医院收治的160例前列腺增生拟行前列腺电切术患者作为研究对象,按照随机数字表法将其分为对照组与观察组,每组各80例。对照组患者采用术后镇痛泵镇痛,观察组患者采用多模式镇痛。比较两组患者的膀胱痉挛发生情况、视觉模拟量表(VAS)评分、非甾体类镇痛药物用量、镇痛药物不良反应发生情况及术后恢复情况。结果观察组患者术后膀胱痉挛发生次数少于对照组,持续时间短于对照组,VAS评分低于对照组,差异有统计学意义(P<0.05)。观察组患者术中、术后及总非甾体类镇痛药物用量均低于对照组,差异有统计学意义(P<0.05)。观察组患者术后镇痛药物不良反应总发生率低于对照组,差异有统计学意义(P<0.05)。观察组患者术后下床活动时间、排气时间及出院时间均短于对照组,差异有统计学意义(P<0.05)。结论多模式镇痛联合应用能够改善前列腺电切患者镇痛效果,减少麻醉不良反应,加速患者术后康复过程。

Objective To investigate the application of multimodal analgesia based on the concept of accelerated rehabilitation surgery in transurethral resection of prostate.Methods A total of 160 patients who underwent transurethral resection of prostate for prostatic hyperplasia in the Second People′s Hospital of Neijiang City from January 2017 to December 2018 were selected as the research objects and divided into the control group and the study group according to random number table method,with 80 cases in each group.The control group was treated with postoperative analgesia pump,and the observation group was treated with multi-mode analgesia.The incidence of bladder spasm,visual analog scale(VAS)score,dosage of non-steroidal analgesic drugs,the incidence of adverse reactions to analgesic drugs and postoperative recovery were compared between the two groups.Results The frequency of postoperative bladder spasm in observation group was less than that in control group,duration of postoperative bladder spasm was shorter than that in control group,the VAS score was lower than that in the control group,and the differences were statistically significant(P<0.05).The amount of intraoperative,postoperative and total non-steroidal analgesic drugs in observation group were lower than those in control group,and the differences were statistically significant(P<0.05).The total incidence of postoperative analgesic drugs in observation group was lower than that in control group,and the difference was statistically significant(P<0.05).Postoperative activity time,exhaust time and discharge time in observation group were shorter than those in control group,and the differences were statistically significant(P<0.05).Conclusions The combined application of multimodal analgesia can improve the analgesic effect of patients undergoing electrotomy of prostate,reduce adverse anesthetic reactions,and accelerate the postoperative rehabilitation process of patients.