布托啡诺与罗哌卡因TAPB对妇科肿瘤腹腔镜手术患者的止痛效果及加速康复的影响  

Effect of butorphanol and ropivacaine TAPB on the analgesic effect and accelerated recovery of patients withgynecological tumor undergoing laparoscopic surgery

作　　者：刘燃[1] 刘海旺[2] 李玲[1] 刘晶晶 缪凡 于超 LIU Ran;LIU Hai-wang;LI Ling;LIU Jing-jing;MIAO Fan;YU Chao(Department of Anesthesiology,The Affiliated Hospital of Chengde Medical University,Chengde 067000 Hebei,China;Department of Pathology,The Affiliated Hospital of Chengde Medical University,Chengde 067000 Hebei,China;Department of Pharmacy,Chengde Central Hospital,Chengde 067000 Hebei,China;Department of Anesthesiology,Chengde Central Hospital,Chengde 067000 Hebei,China)

机构地区：[1]承德医学院附属医院麻醉科,河北承德067000 [2]承德医学院附属医院病理科,河北承德067000 [3]承德市中心医院药剂科,河北承德067000 [4]承德市中心医院麻醉科,河北承德067000

出　　处：《川北医学院学报》2023年第1期68-71,共4页Journal of North Sichuan Medical College

基　　金：河北省承德市科技计划项目(202006A045)。

摘　　要：目的:探讨布托啡诺与罗哌卡因腹横肌平面阻滞(TAPB)对妇科肿瘤腹腔镜手术患者的止痛效果及加速康复的影响。方法:选取60例拟行腹腔镜手术妇科肿瘤患者为研究对象,按照TAPB注入的麻醉药物不同分为对照组和研究组,每组各30例。对照组每侧注入0.375%盐酸罗哌卡因注射液20 mL+0.9%氯化钠溶液1 mL;研究组每侧注入0.375%盐酸罗哌卡因注射液20 mL+0.1%酒石酸布托啡诺注射液1 mL。比较两组患者术中不同时刻心率(HR)和平均动脉压(MAP)水平,术中丙泊酚、瑞芬太尼用量,术后不同时刻视觉模拟评分(VAS),血清白细胞介素-6(IL-6)、IL-10含量,身体康复相关指标及药物不良反应发生率。结果:研究组切皮后5 min HR、MAP水平、术中瑞芬太尼用量及术后6、12、24 h VAS评分及术后24 h血清IL-6含量均低于对照组(P<0.05);排气时间、下床活动时间及住院时间均短于对照组(P<0.05);术后24 h IL-10含量、QoR-40评分均高于对照组(P<0.05)。结论:布托啡诺与罗哌卡因TAPB有利于维持妇科肿瘤腹腔镜手术患者术中血流动力学稳定,降低术中瑞芬太尼用量,提高止痛效果,加速术后康复进程,降低不良反应发生率,具有较高的安全性。Objective:To investigate the effect of butorphanol and transversus abdominis plane block(TAPB) with ropivacaine on the analgesic effect and accelerated recovery of patients withgynecological tumor undergoing laparoscopic surgery.Methods:60 patients undergoing laparoscopic surgery for gynecological tumors were selected and divided into control group and study group according to different anesthetics injected by TAPB,30 cases in each group.The control group was given 0.375% ropivacaine injection 20 mL + 0.9% sodium chloride solution 1 mL each side, the experiment group was given 0.375% ropivacaine hydrochloride injection 20 ml + 0.1% butorphanol tartrate injection 1 mL.The levels of heart rate(HR) and mean arterial pressure(MAP) at different time during operation, the dosage of propofol and remifentanil during operation, the visual analogue scale(VAS) score at different time after operation, the levels of serum interleukin-6(IL-6) and interleukin-10(IL-10) at different time, physical rehabilitation indexes and the incidence of adverse drug reactions were compared between the two groups.Results:The HR and MAP levels at 5 min, the dosage of remifentanil and VAS scores at 6,12 and 24 h after operation, and the serum IL-6 content at 24 h after operation in the study group were lower than those in the control group(P<0.05).The exhaust time, ambulation time and hospitalization time in the study group were shorter than those in the control group(P<0.05).The IL-10 content and the QoR-40 score at 24 h after operation in the study group were higher than those in the control group(P<0.05).Conclusion:Butorphanol and ropivacaine TAPB can maintain hemodynamic stability in patients withgynecological tumor undergoing laparoscopic surgery, reduce the dosage of remifentanil, improve the analgesic effect, accelerate the postoperative recovery, reduce the incidence of adverse reactions, and have high safety.

关 键 词：腹腔镜 布托啡诺 罗哌卡因 腹横肌平面阻滞 镇痛 

分 类 号：R614[医药卫生—麻醉学] R713.4[医药卫生—外科学]