Application of multimodal analgesia regimen in postoperative pain management after laparoscopic sleeve gastrectomy
- VernacularTitle:多模式镇痛方案在腹腔镜袖状胃切除术后疼痛管理中的应用
- Author:
Min CHEN
1
;
Hongshan DAI
2
;
Zhiwei JIANG
2
;
Shupei LI
1
;
Miaoshi YAO
1
;
Yachun SHU
1
Author Information
1. Dept. of Pharmacy，Affiliated Hospital of Nanjing University of Chinese Medicine/Jiangsu Province Hospital of Chinese Medicine，Nanjing 210029，China
2. Dept. of General Surgery，Affiliated Hospital of Nanjing University of Chinese Medicine/Jiangsu Province Hospital of Chinese Medicine，Nanjing 210029，China
- Publication Type:Journal Article
- Keywords:
multimodal analgesia;
laparoscopic sleeve gastrectomy;
pain score;
postoperative pain management
- From:
China Pharmacy
2024;35(21):2658-2662
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To explore the safety， effectiveness and cost-effectiveness of a multimodal analgesic regimen in patients who underwent laparoscopic sleeve gastrectomy under the guidance of enhanced recovery after surgery principles. METHODS Data from weight loss patients who underwent laparoscopic sleeve gastrectomy at our hospital were retrospectively collected. The trial group patients received a multimodal analgesic regimen， which included the use of 0.375% ropivacaine for local infiltration of the surgical incision before the end of surgery； intravenous infusion of flurbiprofen axetil 50 mg twice daily； intravenous infusion of methylprednisolone 40 mg once daily and oral administration of extended-release hydrocodone hydrochloride tablets 10 mg twice daily after surgery. The control group patients received a conventional analgesic regimen， which included intravenous infusion of flurbiprofen axetil 100 mg twice daily， with a daily dose twice that of the trial group； and intravenous injection of dexamethasone 5 mg once daily. Propensity score matching was used to balance the baseline data between the two groups. Then the pain scores during movement and at rest at 2， 12， 24 and 36 hours postoperatively， as well as the length of postoperative hospital stay， total length of hospital stay， time to first ambulation after surgery， adverse reactions during hospitalization， total drug costs， and costs of antimicrobial drugs during hospitalization were compared between the two groups. RESULTS The trial group had significantly lower pain scores during movement at 2， 24 and 36 hours postoperatively， and at rest at 2， 12 and 24 hours postoperatively compared to the control group （P＜0.05）. The time to first ambulation after surgery， total length of hospital stay， and length of postoperative hospital stay were significantly shorter in the trial group compared to the control group （P＜0.05）. The incidence of shoulder and back soreness， and costs of antimicrobial drugs were significantly lower in the trial group compared to the control group （P＜0.05）. No statistically significant differences were observed in the total incidence of drug-related adverse reactions and total drug costs during hospitalization between the two groups （P＞0.05）. CONCLUSIONS The multimodal analgesic regimen provides marked pain relief， demonstrates good safety profiles， and has a more economic advantage than the conventional analgesic regimen.
