超声引导下腹横肌平面阻滞中罗哌卡因在腹腔镜胃癌根治术后镇痛中的应用效果

Application effect of ultrasound-guided transversus abdominis plane block with Ropivacaine for postoperative analgesia in laparoscopic gastrectomy for gastric cancer

目的探讨超声引导下腹横肌平面阻滞中罗哌卡因在腹腔镜胃癌根治术后镇痛的应用效果。方法选取2019年11月至2022年3月钦州市第一人民医院收治的60例接受腹腔镜胃癌根治术患者作为研究对象,按随机数字表法将其分为观察组(30例)与对照组(30例),观察组患者采用超声引导下腹横肌平面阻滞联合罗哌卡因镇痛,对照组采用肌注曲马多镇痛。比较两组患者术后恢复情况、视觉模拟评分法(VAS)评分、Ramsay镇静评分、匹兹堡睡眠质量指数量表(PSQI)评分及不良反应等。结果观察组术后首次排气时间、首次进食时间、首次下床活动及总住院天数均短于对照组,术后VAS评分、不良反应总发生率低于对照组,术后PSQI评分均低于对照组,总住院费用少于对照组,差异有统计学意义(P<0.05)。结论在腹腔镜胃癌根治术后,采用超声引导下腹横肌平面阻滞联合罗哌卡因进行镇痛可使患者术后疼痛轻微,不良反应较少,康复速度较快,住院费用较低,预后较好,具有较高的应用价值。

Objective To investigate the application effect of ultrasound-guided transversus abdominis plane block with Ropivacaine for postoperative analgesia in laparoscopic gastrectomy for gastric cancer.Methods A total of 60 patients undergoing laparoscopic gastrectomy for gastric cancer treated in the First People's Hospital of Qinzhou from November 2019 to March 2022 were selected as the research objects,and they were divided into observation group(30 cases)and control group(30 cases)according to random number table method.Patients in the observation group were treated with ultrasound-guided transversus abdominis plane block combined with Ropivacaine analgesia.The control group was given intramuscular Tramadol analgesia.Postoperative recovery,visual analogue scale(VAS)score,Ramsay sedation score,Pittsburgh sleep quality index(PSQI)score and adverse reactions were compared between the two groups.Results The postoperative first exhaust time,the first meal time,the first out of bed activity,and total length of hospital stay in the observation group were shorter than those in the control group,the postoperative VAS score and total incidence of adverse reactions were lower than those in the control group,PSQI scores were lower than those of control group,the total hospitalization cost was lower than that of control group,the differences were statistically significant(P<0.05).Conclusion After laparoscopic gastrectomy for gastric cancer,the use of ultrasound-guided transversus abdominis plane block with Ropivacaine for analgesia can reduce postoperative pain and adverse reactions,have faster speed of recovery,lower hospitalization cost and better prognosis,and have high application value.