0.5%罗哌卡因局部浸润麻醉对经闭孔路径阴道无张力尿道中段悬吊术术后镇痛的疗效分析

Analysis of the efficacy of using 0.5%ropivacaine local infiltration analgesia on post-operative pain of TVT-O operation

目的 评估术中应用0.5%罗哌卡因局部浸润麻醉对接受经闭孔路径阴道无张力尿道中段悬吊术(transobturator tension-free vaginal tape,TVT-O)的女性压力性尿失禁(stress urinary incontinence,SUI)患者术后疼痛控制效果。方法 回顾性分析2020年1月至2021年12月于首都医科大学附属北京朝阳医院泌尿外科住院的SUI患者病历资料。所有患者均行TVT-O手术,将术中使用0.5%罗哌卡因局部浸润的患者纳入观察组,未使用0.5%罗哌卡因局部浸润的患者纳入对照组,记录两组患者的临床特征并统计分析术后2h静息状态、抬腿状态的视觉模拟评分法(visual analogue scale,VAS)。结果 共纳入253例患者,观察组147例,年龄(57.13±10.31)岁,体质指数24.64(22.95,27.34)kg/m~2;对照组106例,年龄(55.79±9.44)岁,体质指数24.75(22.53,27.31)kg/m~2。观察组术后2h静息状态VAS评分明显低于对照组[1.0(0,1.5)分比2.0(1.0,2.5)分,P<0.001],观察组术后2h抬腿状态VAS评分显著低于对照组[2.0(1.5,2.5)分比3.0(3.0,4.0)分,P<0.001];差异具有统计学意义。所有患者行TVT-O手术治疗后症状改善,两组患者均无不良反应发生。结论 0.5%罗哌卡因局部浸润麻醉在SUI患者TVT-O术后镇痛效果显著。

Objective To evaluate the effect of 0.5%ropivacaine during local infiltration analgesia on postoperative pain control in female patients with stress urinary incontinence(SUI)who underwent transobturator tension-free vaginal tape(TVT-O).Methods The data of SUI patients who hospitalized in the Department of Urology,Beijing Chaoyang Hospital from January 2020 to December 2021 were retrospectively analyzed.All patients underwent TVT-O surgery.The patients who used 0.5%ropivacaine during intraoperative local infiltration were included in the observation group,and those who did not use ropivacaine for local infiltration were included in the control group.The clinical characteristics of the two groups,2h postoperative resting state and leg elevation status by visual analogue scale(VAS)were recorded and compared.Results A total of 253 patients were included.147 patients were divided into the observation group,with age of 57.13±10.31 years and body mass index(BMI)of 24.64(22.95,27.34)kg/m2;while 106 patients into the control group,with age of 55.79±9.44 years and BMI of 24.75(22.53,27.31)kg/m2.All patients treated with TVT-O surgery improved their symptoms.The VAS score in the postoperative resting state was significantly lower in the observation group than in the control group[1.0(0.0,1.5)vs.2.0(1.0,2.5),P<0.001],and the VAS score in the postoperative leg elevation state was significantly lower in the observation group than in the control group[2.0(1.5,2.5)vs.3.0(3.0,4.0),P<0.001].The differences were statistically significant.Conclusions It is worth to recommend local infiltration of 0.5%ropivacaine is effective during local infiltration analgesia to control postoperative pain in SUI patients who undergo TVT-O.