超早期饮食联合罗哌卡因腹横肌平面阻滞镇痛在腹腔镜大肠癌患者康复中的应用研究

Application of ultra-early diet combined with ropivacaine for transverse abdominis plane block analgesia in the rehabilitation of patients with laparoscopic colorectal cancer

目的观察超早期饮食联合罗哌卡因腹横肌平面(TAP)阻滞镇痛在腹腔镜大肠癌患者康复中的应用效果。方法选择该院胃肠外科2021年1月至2023年1月收治的行腹腔镜根治术的大肠癌患者120例,将其随机分为试验组和对照组,各60例。试验组在术后接受超早期饮食联合0.375%罗哌卡因20 mL超声引导下TAP阻滞镇痛及康复治疗,对照组常规术后使用曲马朵止痛。对比两组术后镇痛效果、胃肠功能恢复情况、不良反应、住院时间及治疗费用等。结果试验组术后2、4、12、24 h时疼痛视觉模拟评分均低于对照组,且排气、初次饮水、初次饮食、下床活动、住院时间及住院费用均优于对照组,不良反应发生率低于对照组,差异均有统计学意义(P<0.05)。结论超早期饮食联合罗哌卡因TAP阻滞镇痛可显著缓解腹腔镜大肠癌患者术后疼痛,缩短肠胃恢复时间,促进其早期下床活动,缩短住院时间,减轻治疗费用,提高其生活质量,值得临床推广应用。

Objective To observe the effect of ultra-early diet combined with ropivacaine transverse abdominis plane(TAP)block analyesia in the rehabilitation of patients with laparoscopic colorectal cancer.Methods From January 2021 to January 2023,a total of 120 patients with colorectal cancer who underwent laparoscopic radical resection in the Gastrointestinal Department of this hospital were selected and randomly divided into the experimental group and the control group,with 60 patients in each group.The experimental group received ultra-early diet combined with 0.375%ropivacaine 20 mL ultrasound guided TAP block analgesia and rehabilitation treatment after surgery,while the control group used tramadol to relieve pain after routine surgery.The postoperative analgesic effect,gastrointestinal function recovery,adverse reactions,hospital stay,and treatment costs were compared between the two groups.Results The pain visual analogue score in the experimental group was lower than that in the control group at 2,4,12,24 hours after surgery;The exhaust,initial drinking water,initial diet,ambulatory activities times,hospitalization days,and hospitalization expenses in the control group were better than those in the control group;The incidence of adverse reactions was lower than that of the control group,the differences were statistically significant(P<0.05).Conclusion Ultra-early diet combined with ropivacaine TAP block analgesia can significantly alleviate postoperative pain,shorten gastrointestinal recovery time,promote early ambulation,shorten hospital stay,reduce treatment costs,and improve quality of life in patients with laparoscopic colorectal cancer,which is worthy of clinical promotion and application.