Effect of transversus abdominis plane block combined with diclofenac sodium suppositories on postopera-tive early recovery after laparoscopic hysterectomy
10.12089/jca.2018.04.012
- VernacularTitle:超声引导下腹横肌平面阻滞联合双氯芬酸钠栓对腹腔镜下子宫切除患者术后早期恢复的影响
- Author:
Weiqiang ZHUANG
1
;
Donghui LI
;
Wenji XIE
;
Chunmei HUANG
;
Honghong LIN
;
Huihuang WANG
Author Information
1. 362100,福建省惠安县医院麻醉
- Keywords:
Transversus abdominis plane;
Diclofenac sodium suppositories;
Postoperative analgesia;
Recovery
- From:
The Journal of Clinical Anesthesiology
2018;34(4):363-366
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the effect of ultrasound-guided transversus abdominis plane block combined with diclofenac sodium suppository in anus on postoperative analgesia and early recov-ery after laparoscopic hysterectomy.Methods Sixty-six patients of laparoscopic hysterectomy,aged 40-60 years,were randomly divided into group T and group D,33 cases in each group.Group T used ultrasound-guided bilateral transversus abdominis plane (TAP)block after surgery.Group D used TAP block and diclofenac sodium suppositories in anus.All patients received PCIA.Postoperative 24 h sufentanil dosage out of analgesia pump and the effective press times were recorded.The incidence of dysphoria,nausea and vomit within postoperative 24 h,the time of first out-of-bed activity,the time of first anal exhaust and the time of removing urine tube were measured.The plasma concentra-tion of interleukin-6(IL-6),C reactive protein (CRP)and cortisol (Cor)were recorded at the follow-ing four time points:before anesthesia,just postoperative moment,8 and 12 h after surgery. Results Compared with group T,the sufentanil dosage [(18.6±3.2)μg vs (40.8±5.1)μg]and the effective press times [(9.3±2.2)times vs (20.4±3.5)times]were fewer in group D (P<0.05).The incidence of dysphoria,and nausea and vomit were less in group D compared with group T (P<0.05).The IL-6,CRP and Cor of group D at 12 h were lower than those of group T (P<0.05). But the times of first out-of-bed activity,anal exhaust and removing urine tube in two groups were not significantly different.Conclusion Transversus abdominis plane block combined with diclofenac sodium suppositories in anus can provide safe and effective postoperative analgesia for laparoscopic hysterectomy,and promote the early fast recovery.