Department of Anaesthesiology, The First People's Hospital of Wenling, Taizhou 317500, Zhejiang, China.
J Healthc Eng. 2021 Jul 22;2021:5169803. doi: 10.1155/2021/5169803. eCollection 2021.
This paper aimed to study the application of local anesthetics combined with transversus abdominis plane (TAP) block in gynecological laparoscopy (GLS) surgery during perioperative period under the guidance of ultrasound image enhanced by the wavelet transform image enhancement (WTIE) algorithm. 56 patients who underwent GLS surgery in hospital were selected and classified as the infiltrating group and block group. The puncture needle was guided by ultrasound images under WTIE algorithm, and 0.375% ropivacaine was adopted to block TAP. The results showed that the dosage of propofol in the infiltrating group (313.23 ± 19.67 mg) was remarkably inferior to the infiltrating group (377.67 ± 21.56 mg) ( < 0.05). The hospitalization time of patients in the infiltrating group (2.14 ± 0.18 days) was obviously shorter than that of the infiltrating group (3.23 ± 0.27 days) ( < 0.05). 3 h, 6 h, and 12 h after the operation, the visual analogue scores (3.82 ± 1.58 points, 2.97 ± 1.53 points, and 1.38 ± 0.57 points) of the patients in the infiltration group were considerably higher than the infiltrating group (2.31 ± 1.46 points, 1.06 ± 1.28 points, and 0.95 ± 0.43 points) ( < 0.05). 3 h, 6 h, and 12 h after the operation, the number of patients in the infiltrating group who used tramadol for salvage analgesia (2 cases, 1 case, and 1 case) was notably less than that in the infiltration group (9 cases, 7 cases, and 3 cases) ( < 0.05). In short, local anesthetics combined with TAP block can reduce postoperative VAS score and postoperative nausea and vomiting (PONV) score, which also reduced the incidence of postoperative analgesia.
本文旨在研究在经皮神经电刺激（TENS）引导下应用局部麻醉药联合腹横肌平面（TAP）阻滞在妇科腹腔镜（GLS）手术围手术期的应用。选取在我院行 GLS 手术的 56 例患者，分为浸润组和阻滞组。采用超声图像增强的小波变换图像增强（WTIE）算法引导穿刺针，采用 0.375%罗哌卡因行 TAP 阻滞。结果显示，浸润组（313.23±19.67mg）的丙泊酚用量明显低于浸润组（377.67±21.56mg）（<0.05）。浸润组患者住院时间（2.14±0.18 天）明显短于浸润组（3.23±0.27 天）（<0.05）。术后 3h、6h、12h，浸润组患者的视觉模拟评分（3.82±1.58 分、2.97±1.53 分、1.38±0.57 分）明显高于浸润组（2.31±1.46 分、1.06±1.28 分、0.95±0.43 分）（<0.05）。术后 3h、6h、12h，浸润组需要曲马多补救镇痛的患者人数（2 例、1 例、1 例）明显少于浸润组（9 例、7 例、3 例）（<0.05）。总之，局部麻醉药联合 TAP 阻滞可降低术后 VAS 评分和术后恶心呕吐（PONV）评分，也降低了术后镇痛的发生率。
