Zhu Rong-Yu, Xiang Si-Qu, Chen Dou-Ren
Department of Anesthesiology, Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi 445000, Hubei Province, China.
Department of Pharmacy, Huai'an Hospital Affiliated to Xuzhou Medical University, Huai'an 223002, Jiangsu Province, China.
World J Clin Cases. 2021 Dec 6;9(34):10540-10548. doi: 10.12998/wjcc.v9.i34.10540.
Laparoscopic surgery has become a common surgical approach for the clinical treatment of intra-abdominal lesions in recent years. We hypothesized that lumbar block with postoperative patient-controlled intravenous analgesia (PCIA) by butorphanol after gynecological surgery under general anesthesia would be more effective than PCIA by butorphanol alone.
To investigate the effect of lumbar block with PCIA by butorphanol after gynecological surgery under general anesthesia.
This study assessed 120 women scheduled for laparoscopic surgery at our hospital between May 2017 and May 2020. They were divided using a random number table into a research group (those who received quadratus lumborum block combined with PCIA analgesia by butorphanol) and a control group (those who received only PCIA analgesia by butorphanol), with 60 patients in each group. Demographic factors, visual analog scale scores for pain, serum inflammatory markers, PCIA compressions, Ramsay scores, and adverse events were compared between groups using a -test, analysis of variance, or test, as appropriate.
There were no significant differences in demographic factors between groups (all > 0.05). The visual analog scale scores of the research group in the resting state 12 h and 24 h postoperatively were significantly lower than those of the control group ( < 0.05). Two hours after surgery, there were no significant differences in the levels of serum tumor necrosis factor-α, interleukin (IL)-6, or IL-8 between groups ( > 0.05). The serum tumor necrosis factor-α levels of the research group 24 h postoperatively were significantly lower than those of the control group ( < 0.05). The levels of serum IL-6 and IL-8 in the study group 24 h and 48 h postoperatively were significantly lower than those in the control group ( < 0.05).
Lumbar block with PCIA with butorphanol after gynecological surgery under general anesthesia significantly improves the analgesic effect and reduces the degree of inflammation, instances of PCIA compression, and adverse reactions.
近年来，腹腔镜手术已成为临床治疗腹腔内病变的常用手术方式。我们假设，全身麻醉下妇科手术后采用布托啡诺进行腰麻联合术后患者自控静脉镇痛（PCIA）比单纯使用布托啡诺进行PCIA更有效。
探讨全身麻醉下妇科手术后采用布托啡诺进行腰麻联合PCIA的效果。
本研究评估了2017年5月至2020年5月在我院计划进行腹腔镜手术的120名女性。使用随机数字表将她们分为研究组（接受腰方肌阻滞联合布托啡诺PCIA镇痛的患者）和对照组（仅接受布托啡诺PCIA镇痛的患者），每组60例。根据情况，使用t检验、方差分析或卡方检验比较两组之间的人口统计学因素、疼痛视觉模拟评分、血清炎症标志物、PCIA按压次数、Ramsay评分和不良事件。
两组之间的人口统计学因素无显著差异（均P>0.05）。研究组术后12小时和24小时静息状态下的视觉模拟评分显著低于对照组（P<0.05）。术后2小时，两组之间血清肿瘤坏死因子-α、白细胞介素（IL）-6或IL-8水平无显著差异（P>0.05）。研究组术后24小时血清肿瘤坏死因子-α水平显著低于对照组（P<0.05）。研究组术后24小时和48小时血清IL-6和IL-8水平显著低于对照组（P<0.05）。
全身麻醉下妇科手术后采用布托啡诺进行腰麻联合PCIA可显著提高镇痛效果，降低炎症程度、PCIA按压次数和不良反应。
