多模式镇痛用于腹腔镜子宫肌瘤切除术的镇痛效果及对应激反应的影响

目的]探讨多模式镇痛用于腹腔镜子宫肌瘤切除术的镇痛效果及对应激反应的影响.方法]本院收治的100例子宫肌瘤患者随机分为观察组与对照组,每组各50例.两组均采取腹腔镜子宫肌瘤切除术,对照组采取常规全麻+术后静脉自控镇痛(PCIA),观察组采取多模式镇痛.比较两组视觉模拟量表(VAS)疼痛评分及不同时间的镇痛药使用量及按压镇痛泵次数.观察两组术后应激反应指标血管紧张素Ⅱ(AngⅡ)、皮质醇(Cor)、促肾上腺皮质激素释放激素(CRH)、去甲肾上腺素(NE)水平变化和不良反应发生情况.结果]观察组治疗后2 h、4 h、12 h、24 h、48 h的VAS评分明显低于对照组,且差异有显著性(P<0.05).观察组治疗后12 h、24 h、36 h镇痛药使用量及按压镇痛泵次数少于对照组(P<0.05).观察组治疗后AngⅡ、Cor、CRH、NE水平显著低于对照组(P<0.05).两组总不良反应发生率相比较,差异无显著性(P>0.05).结论]多模式镇痛用于腹腔镜子宫肌瘤切除术的镇痛效果显著,可降低患者应激反应,具有较高的临床应用价值.

Analgesic Effect and Stress Respmise of Multimodal Analgesia in Laparoscopic Ilysteromyomectomy

Objective]To explore the analgesic effect and stress response of multimodal analgesia in the application of laparoscopic hysteromyomectomy.Methods]A total of 100 patients with uterine leiomyoma admitted to our hospital were divided into the observation group and the control group by random table method,with 50 cases in each group.Laparoscopic hysteromyomectomy was performed in both groups.The control group received routine general anesthesia plus post-operative PCI A,while the observation group received multimodal analgesia.The pain score of visual analogue scale(VAS),the amount of analgesics used at different time and the pressing times of analgesic pumps were recorded and compared between the two groups.Postoperative stress response indicators such as angiotensinⅡ(AngⅡ),cortisol(Cor),corticotropin releasing hormone(CRH),norepinephrine(NE)levels were measured in both groups.The adverse reactions were also compared in the two groups.Results]The pain scores of the observation group at 2,4,12,24 and 48 hours after treatment were lower than those of the control group(P<0.05).The dosage of analgesics and the number of pre Svsing analgesic pumps in the observation group were lower than those in the control group at 12h,24h and 36h after treatment(P<0.05).AngⅡCor,CRH and NE levels in the observation group were significantly lower than those in the control group(P<0.05).The total incidence of adverse reactions in the two groups was not significant difference(P>0.05).Conclusion]The analgesic effect of multimodal analgesia in laparoscopic hysteromyomectomy is remarkable.It can reduce stress response which has high clinical application value.