鞘内吗啡镇痛与硬膜外镇痛对机器人辅助根治性膀胱切除术患者术后疼痛和并发症的影响  

Effect comparison of intrathecal morphine analgesia and epidural analgesia on postoperative pain and complications in patients undergoing robot-assisted radical cystectomy

作　　者：张进 王学佳 姜蕊 王宏亮 ZHANG Jin;WANG Xuejia;JIANG Rui;WANG Hongliang(Department of Anesthesiology,the Second Affiliated Hospital,the Air Force Medical University,Xi’an 710038,China)

机构地区：[1]空军军医大学第二附属医院麻醉科,陕西西安710038

出　　处：《机器人外科学杂志（中英文）》2024年第3期334-340,共7页Chinese Journal of Robotic Surgery

基　　金：陕西省重点研发计划项目(2021SF-054)。

摘　　要：目的:比较鞘内吗啡与硬膜外镇痛对接受机器人辅助根治性膀胱切除术患者的术后疼痛和并发症的影响。方法:选取2020年1月—2023年6月接受机器人辅助根治性膀胱切除术患者96例,以随机数表法进行分组,分为对照组(硬膜外镇痛,48例)和研究组(鞘内吗啡镇痛,48例),比较两组手术相关指标、术后疼痛和并发症。结果:与对照组比较,研究组排气时间、排便时间、饮食恢复时间、住院时间更短,复发率更低,并发症发生率更低,两组死亡率无统计学意义。两组患者术后12 h、24 h、48 h静息状态VAS评分无统计学意义,与对照组比较,研究组术后12 h、24 h咳嗽状态VAS评分更低。结论:与硬膜外镇痛相比较,鞘内吗啡镇痛应用于接受机器人辅助根治性膀胱切除术患者,可减轻咳嗽状态的疼痛,降低复发率和并发症发生率,促进患者更快康复。Objective:To compare the effects of intrathecal morphine and epidural analgesia on postoperative pain and complications in patients undergoing robot-assisted radical cystectomy.Methods:96 patients who underwent robot-assisted radical cystectomy from January 2020 to June 2023 were selected and divided into the control group(using epidural analgesia,n=48)and the study group(using intrathecal morphine analgesia,n=48)by random number table method.The surgery-related indexes,postoperative pain and complications in the two groups of patients were compared.Results:Compared with the control group,the study group had a less time of exhaust,defecation and dietary recovery,shorter hospital stay,lower recurrence rate and complication rate.However,the mortality rates of the two groups were not statistically significant.There was no statistical significance in the resting visual analogue scale(VAS)score at 12 h,24 h and 48 h after surgery in the two groups.Compared with the control group,the study group had lower cough VAS scores at 12 h and 24 h after surgery.Conclusion:Compared with epidural analgesia,application of intrathecal morphine analgesia to patients undergoing robot-assisted radical cystectomy can reduce the pain of patients when coughing,decrease the recurrence rate and complication rate,and promote recovery.

关 键 词：鞘内吗啡镇痛 硬膜外镇痛 机器人辅助手术 根治性膀胱切除术 术后疼痛 并发症 

分 类 号：R614[医药卫生—麻醉学] R737.14[医药卫生—外科学]