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| Analgesic Effect and Stress Response of Multimodal Analgesia in Laparoscopic Hysteromyomectomy |
| LUO Hai-ming, JING Shan-liang, KUANG Yan |
| Department of Anesthesiology, Shanghai Ninth Peoples Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 201900 |
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Abstract 【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 PCIA, 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 angiotensin Ⅱ(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 pressing analgesic pumps in the observation group were lower than those in the control group at 12h, 24h and 36h after treatment (P<0.05). AngⅡ, Cor, 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.
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Received: 15 July 2019
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[1] 李岩, 曲亚兰, 李丹阳,等. 米非司酮预防子宫肌瘤患者术后复发的疗效观察[J].医学临床研究, 2015,32(3):499-504.
[2] 耿昕, 刘占豪, 黄明. 全胸腔镜手术切除原发性纵隔肿瘤[J].现代仪器与医疗, 2017, 23(2):19-20.
[3] 韩友领, 刘功俭. 右美托咪定在舒芬太尼联合氟比洛芬酯术后自控静脉镇痛中的应用效果评价[J].实用临床医药杂志, 2016, 20(17):160-162.
[4] 胡兰,林静,何伟.局麻辅助镇静镇痛药物在斜视手术中的疗效观察[J].中国斜视与小儿眼科杂志, 2017, 25(4)17-19.
[5] Santosh BS, Gopalakrishna MS.Does dexmedetomidine improve analgesia of superficial cervical plexus block for thyroid surgery[J].Ind J Anaesthesia,2016, 60(1):34-38.
[6] 张阿曼, 裴晓娟, 张鸿,等. 右美托咪定对行腹腔镜术妇科疾病患者术后VAS评分影响及安全性研究[J].陕西医学杂志, 2018, 47(1):87-89.
[7] 唐向盛. 罗哌卡因在后路腰椎融合术多模式镇痛中的临床应用[J].中国矫形外科杂志, 2017, 25(1):20-24.
[8] 钟帝钦, 王志鹏, 蔡锦锴,等. 乳腺癌根治术经超声引导术侧前锯肌平面阻滞技术在术后镇痛中的效果分析[J].中国医师进修杂志, 2017, 40(8):677-680.
[9] 赖红燕, 吕俊英, 黄小燕,等. 舒芬太尼注射液联合氟比洛芬酯注射液在下肢多发骨折术后镇痛的临床研究[J].中国临床药理学杂志, 2016, 32(22):2066-2068.
[10] 苗茜, 戴丽, 邵青,等. 氟比洛芬酯、舒芬太尼、高乌甲素复合曲马多用于腹腔镜胆囊切除术后静脉镇痛对凝血功能的影响和安全性比较[J].重庆医学, 2016,45(3):303-305.
[11] 蔡炜. 多模式镇痛在全膝关节置换术中的临床疗效及对应激反应的影响[J].四川医学, 2015,36(3):371-373.
[12] Yu JM, Sun H, Wu C, et al. The analgesic effect of ropivacaine combined with dexmedetomidine for incision infiltration after laparoscopic cholecystectomy[J].Surg Laparosc Endosc Percutan Tech,2016, 26(6):449-454. |
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2020, Vol. 37 
