The clinical effect of hydromorphone combined with ropivacaine in abdominal transverse plane block after laparoscopic myomectomy and its effect on stress response
10.3760/cma.j.cn115455-20200628-00808
- VernacularTitle:氢吗啡酮复合罗哌卡因腹横肌平面阻滞应用于腹腔镜子宫肌瘤手术的临床效果观察及对应激反应的影响
- Author:
Pengsong SHI
;
Qing QIAO
- From:
Chinese Journal of Postgraduates of Medicine
2021;44(2):175-179
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical effect of hydromorphone combined with ropivacaine and its effect on stress response after laparoscopic myomectomy.Methods:From March 2017 to March 2020 in Shangyu Hospital of Traditional Chinese Medicine, Zhejiang Province, 100 patients who were performed laparoscopic hysteromyoma were randomly divided into observation group (50 cases) and control group (50 cases). Both groups were treated with plane block of transverse abdominal muscle after anesthesia induction. The control group was injected with ropivacaine, and the observation group was injected with hydromorphone and ropivacaine. The changes of hemodynamics at the time of entering operation room (T 0), 1 h after operation (T 1) and after surgery (T 2) were compared between two groups. The visual analogue scale (VAS) score at postoperative 3 h, 12 h and 24 h, Ramsay sedation score during operation, and serum stress level at preoperative and postoperative 24 h were compared between two groups. Results:The levels of heart rate, systolic and diastolic blood pressure between the two groups at different times had no significant differences ( P>0.05). The VAS scores of the observation group at postoperative 3 h, 12 h and 24 h were lower than those in control group [(3.05 ± 0.32) scores vs. (3.42 ± 0.39) scores, (2.16 ± 0.38) scores vs. (2.73 ± 0.43) scores, (1.43 ± 0.29) scores vs. (2.28 ± 0.35) scores], and there were significant differences ( t = 5.186, 7.024, 13.223, P<0.05). The scores of Ramsay sedation score in observation group was higher than that in control group [(3.79 ± 0.45) scores vs. (2.54 ± 0.39) scores], and there was significant difference ( t = 14.843, P<0.05). The levels of noradrenaline, interleukin-6, and cortisol in observation group at postoperative 24 h were lower than those in control group [(254.18 ± 14.35) pmol/L vs. (328.73 ± 18.69) pmol/L, (26.89 ± 4.10) ng/L vs. (35.27 ± 5.46) ng/L, (214.30 ± 21.28) pmol/L vs. (296.53 ± 32.19) pmol/L], and there were significant differences ( t = 22.371, 8.678, 15.068, P<0.05). Conclusions:The combination of hydromorphone and ropivacaine in abdominal transverse plane block after laparoscopic myomectomy has good analgesic and sedative effects and can reduce stress response.
