超声引导下腹横肌平面阻滞对机器人辅助全子宫切除术后疼痛的影响

Effect of ultrasound-guided transversus abdominis plane block on postoperative pain in robot-assisted total hysterectomy

目的:探讨超声引导下腹横肌平面阻滞(TAPB)对机器人辅助全子宫切除术后疼痛的影响。方法:选取2020年1月—2022年12月行机器人辅助全子宫切除术的患者102例,按照随机数表法分为对照组(静脉镇痛,51例)和研究组(超声引导下TAPB,51例),比较两组患者术后疼痛情况。结果:与对照组比较,研究组术后4 h、8 h、12 h、24 h的非切口痛(NWP)发生率更低,术后4 h、8 h、12 h、24 h、48 h静息时和咳嗽时视觉模拟评分法(VAS)评分更低,术后3个月、6个月、12个月慢性术后疼痛(CPSP)发生率更低,术后3个月、6个月病理学疼痛(NP)发生率更低。两组术后48 h NWP发生率、术后12个月CPSP发生率无明显差异。结论:超声引导下TAPB应用于机器人辅助全子宫切除术,可减轻术后急性和慢性疼痛。

Objective:To explore the effect of ultrasound-guided transversus abdominis plane block(TAPB)on acute and chronic postoperative pain after robot-assisted total hysterectomy.Methods:102 patients who underwent robot-assisted total hysterectomy in the Northwest Women’s and Children’s Hospital from January 2020 to December 2022 were selected and divided into the control group(n=51)and the study group(n=51)using the random number table method.Patients in the control group were given intravenous analgesia and the study group received ultrasound-guided TAPB.The postoperative pain of the patients in the two groups was compared.Results:Compared with the control group,the study group had a lower incidence of non-incisional pain(NWP)at 4 h,8 h,12 h,and 24 h after surgery,lower VAS scores when resting and coughing at 4 h,8 h,12 h,and 24 h after surgery,and a lower incidence of chronic post-surgical pain(CPSP)at 3,6,and 12 months after surgery.The study group also had a lower incidence of pathological pain(NP)than that of the control group.There was no significant difference in the incidence of NWP at 48 h after surgery and CPSP at 12 months after surgery between the two groups.Conclusion:Application of ultrasound-guided TAPB in robot-assisted total hysterectomy could reduce both acute and chronic pain after surgery.