达芬奇机器人结直肠手术加速康复外科围手术期多模式止痛研究  

Study on perioperative multimodal analgesia in Da Vinci robotic colorectal surgery under ERAS

作　　者：李玉萍 柳欣欣 刘江 江志伟 章程 邵明月 龚冠闻 王刚[1] LI Yuping;LIU Xinxin;LIU Jiang;JIANG Zhiwei;ZHANG Cheng;SHAO Mingyue;GONG Guanwen;WANG Gang(General Surgery Department,Jiangsu Provincial Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Traditional Chinese Medicine,Nanjing 210029,China)

机构地区：[1]南京中医药大学附属江苏省中医院普通外科,江苏南京210029

出　　处：《机器人外科学杂志（中英文）》2022年第4期311-318,共8页Chinese Journal of Robotic Surgery

基　　金：湖北陈孝平科技发展基金(CXPJJH118000017-02-02)。

摘　　要：目的:在围手术期加速康复模式下应用多模式止痛方案,观察达芬奇机器人结直肠手术患者的术后镇痛及康复情况,并探讨针对内脏痛的纳布啡在术后患者加速康复中的应用价值。方法:随机选择100例择期行达芬奇机器人结直肠手术的患者,随机分为研究组(多模式镇痛组)和对照组(静脉泵镇痛组)。多模式镇痛组采用纳布啡、非甾体类镇痛药及局部麻醉浸润的联合药物镇痛方案,静脉泵镇痛组为常规静脉镇痛泵组,观察两组患者术后疼痛及康复情况。结果:和常规静脉泵镇痛组相比较,联合纳布啡的多模式镇痛组围手术期尿潴留、便秘、恶心、呕吐、眩晕、嗜睡、呼吸抑制等不良反应均较少,多模式镇痛组术后患者镇痛效果良好,下床活动、胃肠通气、进食时间更早,患者达到快速康复。结论:多模式镇痛方案有助于达芬奇机器人结直肠手术患者的围手术期快速康复,且疼痛控制良好,术后恢复较快。Objective:To observe the postoperative analgesic and rehabilitation effect of patients underwent Da Vinci robotic colorectal surgery with perioperative multimodal analgesia under ERAS,and to explore the clinical value of nalbuphine in patients under ERAS.Methods:100 patients underwent robotic colorectal surgery were randomly selected and divided into the study group and the control group.The study group was given multimodal analgesia combined with nalbuphine,non-steroidal analgesics and local infiltration anesthesia.The control group was given routine intravenous analgesia.The postoperative pain and recovery of the two group were observed.Results:Compared with the control group,the study group had less adverse reactions in terms of perioperative urinary retention,constipation,nausea,vomiting,dizziness,drowsiness and respiratory depression.Postoperative analgesic effect of multimodal analgesia was good,and patients in the study group achieved faster recovery with earlier off-bed time,shorter gastrointestinal ventilation and feeding time.Conclusion:Perioperative multimodal analgesia under ERAS is useful for patients underwent Da Vinci robotic colorectal surgery,which could achieve good analgesic effect and accelerate recovery after surgery.

关 键 词：多模式镇痛 纳布啡 机器人手术 结直肠手术 加速康复外科 

分 类 号：R605[医药卫生—外科学]