罗哌卡因复合布托啡诺腹横肌平面阻滞在腹腔镜下宫颈癌手术患者术后镇痛中的应用效果分析

APPLICATION EFFECT ANALYSIS OF ROPIVACAINE COMBINED WITH BUTORPHANOL TRANSVERSUS ABDOMINIS PLANE BLOCK IN POSTOPERATIVE ANALGESIA OF PATIENTS WITH LAPAROSCOPIC CERVICAL CANCER SURGERY

目的研究罗哌卡因复合布托啡诺腹横肌平面阻滞在腹腔镜下宫颈癌手术患者术后镇痛中的应用效果。方法选取2019年1月—2021年1月该院就诊的124例宫颈癌患者的病历资料进行回顾性分析,根据治疗方式不同,分为对照组(n=61,罗哌卡因治疗)和观察组(n=63,罗哌卡因复合布托啡诺治疗)。比较二组手术情况[手术时间、术中瑞芬太尼用量及术中丙泊酚用量]、疼痛程度[采用疼痛视觉模拟评分(visual analogue scale,VAS)评估]、炎性因子[白介素-6(interleukin-6,IL-6)、白介素-10(interleukin-6,IL-10)]及不良反应。结果二组手术时间、术中丙泊酚用量对比,差异无统计学意义(P>0.05);观察组患者术中瑞芬太尼用量明显少于对照组(P<0.05);观察组患者术后2h、4h、12h、24h的疼痛程度均低于对照组(P<0.05);相比入室后5min,术后2、24h二组IL-6、IL-10均升高(P<0.05);且术后2、24h观察组IL-6水平低于对照组,IL-10水平高于对照组(P<0.05);观察组不良反应发生率(9.52%)与对照组不良反应发生率(13.11%)对比差异无统计学意义(P>0.05)。结论对腹腔镜下宫颈癌手术患者采用罗哌卡因复合布托啡诺进行腹横肌平面阻滞对患者的术后镇痛效果良好,且能减少患者术中瑞芬太尼的用量,改善患者术后机体炎症应激反应,具有一定安全性。

Objective To study the application effect of ropivacaine combined with butorphanol transversus abdominis plane block in postoperative analgesia of patients with laparoscopic cervical cancer surgery.Methods The medical records of one hundred and twenty four patients with cervical cancer who were treated in our hospital from January 2019 to January 2021 were selected for retrospective analysis.According to different treatment methods,they were divided into control group(n=61,ropivacaine treatment)and study group(n=63,ropivacaine combined with butorphanol therapy).Operation conditions[operation time,intraoperative remifentanil dosage and intraoperative propofol dosage],pain degree[assessed by visual analogue scale(VAS)],inflammatory factors[Interleukin-6(IL-6),Interleukin-6(IL-10)]and adverse reactions of the two groups were compared.Results The difference between the operation time and intraoperative propofol dosage in the two groups was not statistically significant(P>0.05);the intraoperative remifentanil dosage in the study group was significantly less than that in the control group(P<0.05);The pain levels of the study group at 2 h,4 h,12 h,and 24 h after operation were lower than those of the control group(P<0.05);compared with 5 min after entering the room,IL-6 and IL-10 were increased in the two groups at 2 h and 24 h after operation(P<0.05);the IL-6 level of the study group was lower than that of the control group at 2 and 24 hours after the operation,and the IL-10 level was higher than that of the control group(P<0.05);The incidence of adverse reactions in the study group(9.52%)was not statistically significant compared with the incidence of adverse reactions in the control group(13.11%)(P>0.05).Conclusion The use of ropivacainecombined with butorphanol for transversus abdominis plane block for patients undergoing laparoscopic cervical cancer surgery has a good postoperative analgesic effect,and can reduce the amount of remifentanil during the operation and improve The postoperative inflammatory stress response of the patient′s body has a certain degree of safety,and it is worthy of clinical use and promotion.