麻醉管理优化在妇科单孔腹腔镜快速康复中的应用

Application of optimized anesthesia management in gynecological single port laparoscopy for enhanced recovery

目的探讨麻醉管理优化方案结合单孔腹腔镜手术对患者快速康复的影响。方法将68例妇科良性肿瘤患者随机分成对照组和ERAS组,对照组患者采用三孔腹腔镜手术结合常规麻醉管理方案,ERAS组患者采用单孔腹腔镜手术结合优化后的麻醉管理方案。比较2组手术时间、拔管时间、复苏室停留时间、达出院标准时间、术后肛门排气时间、术后住院时间及术后30 min、2 h、12 h、24 h VAS评分。比较2组术后恶心呕吐及切口出血、感染等情况。结果ERAS组手术时间、拔管时间、达出院标准时间、术后肛门排气时间、术后住院时间短于对照组,差异均有统计学意义(P<0.05)。2组复苏室停留时间、恶心呕吐发生率比较,差异无统计学意义(P>0.05)。2组患者术后均无切口出血、感染等情况发生。与对照组比较,ERAS组术后30 min VAS评分更高,其余时间点VAS评分更低(P<0.05)。结论优化后的麻醉管理策略结合单孔腔镜手术能减轻患者痛苦,缩短住院时间,促进患者快速康复。

Objective To explore the effect of optimized anesthesia management scheme combined with single-port laparoscopic surgery on patients’enhanced recovery.Methods A total of 68 patients with gynecological benign tumor were randomly divided into the control group and the ERAS group.Patients in the control group were treated with three ports laparoscopic surgery combined with conventional anesthesia management scheme,while those in the ERAS group were treated with single port laparoscopic surgery combined with optimized anesthesia management scheme.The operation time,extubation time,resuscitation room stay,time up to discharge standard,postoperative anal exhaust time,postoperative hospital stay,and VAS scores at 30 minutes,2 hours,12 hours and 24 hours after operation were compared between the two groups.Postoperative nausea and vomiting,incision bleeding and infection were compared between the two groups.Results The operation time,extubation time,time up to discharge standard,postoperative anal exhaust time and postoperative hospital stay of the ERAS group were shorter than those of the control group,the differences were statistically significant(P<0.05).There was no significant difference in resuscitation room stay or the incidence of nausea and vomiting between the two groups(P>0.05).No patient in the two groups developed incision bleeding or infection after operation.Compared with the control group,the VAS score of the ERAS group at 30 minutes after operation was higher,but which were lower at other time points(P<0.05).Conclusion The optimized anesthesia management scheme combined with single-port laparoscopic surgery can reduce the pain of patients,shorten the length of hospital stay and promote enhanced recovery of patients.