腹横筋膜阻滞联合布托啡诺对妇科腹腔镜手术患者术后镇痛效果及VAS评分的影响研究

Impact Study of Transverse Fascia Block Combined with Butorphanol on Postoperative Analgesia Effect and VAS Score in Patients with Gynecologic Operative Laparoscopy

目的:探讨腹横筋膜阻滞联合布托啡诺对妇科腹腔镜手术患者的镇痛效果。方法:选取2020年4月—2022年4月于赣州市妇幼保健院行妇科腹腔镜手术的120例患者,依据术后镇痛方式的不同,分为布托啡诺组、腹横筋膜阻滞组和联合组,每组40例。比较三组患者的麻醉苏醒时间、拔管时间、麻醉后监测治疗室(PACU)停留时间、视觉模拟评分法(VAS)评分、Ramsay镇静评分及并发症发生率。结果:联合组的麻醉苏醒时间、拔管时间和PACU停留时间均短于布托啡诺组和腹横筋膜阻滞组,差异均有统计学意义(P<0.05)。联合组术后3、6、24 h的VAS评分和Ramsay镇静评分均低于布托啡诺组和腹横筋膜阻滞组,联合组术后12 h的VAS评分低于布托啡诺组,Ramsay镇静评分低于布托啡诺组和腹横筋膜阻滞组,差异均有统计学意义(P<0.05)。联合组的并发症总发生率均低于布托啡诺组和腹横筋膜阻滞组,差异均有统计学意义(P<0.05)。结论:对行妇科腹腔镜手术患者采用腹横筋膜阻滞与布托啡诺联合治疗,能有效缩短其恢复时间,改善其疼痛感和镇静状态,减少并发症发生。

Objective:To investigate the analgesic effect of transverse fascia block combined with Butorphanol in gynecologic operative laparoscopy.Method:A total of 120 patients who underwent gynecologic operative laparoscopy in Ganzhou Women and Children's Health Care Hospital from April 2020 to April 2022 were selected and divided into Butorphanol group,transverse fascia block group and combination group according to different postoperative analgesia methods,with 40 cases in each group.The anesthesia recovery time,extubation time,post anesthesia care unit(PACU)residence time,visual analogue scale(VAS)score,Ramsay sedation score and complication rate of the three groups were compared.Result:The anesthesia recovery time,extubation time and PACU residence time in combination group were shorter than those in Butorphanol group and transverse fascia block group,the differences were statistically significant(P<0.05).VAS scores and Ramsay sedation scores at 3,6 and 24 h after operation in combination group were lower than those in Butorphanol group and transverse fascia block group,the VAS score at 12 h after operation in combination group was lower than that in Butorphanol group,and the Ramsay sedation score was lower than that in Butorphanol group and transverse fascia block group,the differences were statistically significant(P<0.05).The total incidence of complications in combination group was lower than that in Butorphanol group and transverse fascia block group,the differences were statistically significant(P<0.05).Conclusion:The combination of transverse fascia block and Butorphanol for patients undergoing gynecologic operative laparoscopy can effectively shorten the recovery time,improve the pain and sedation,and reduce the occurrence of complications.