Effect of LPVS combined with MMA on pulmonary complications and pain in obese patients after LSG surgery
10.3760/cma.j.cn431274-20240421-00682
- VernacularTitle:LPVS联合MMA对肥胖患者LSG术后肺部并发症和疼痛的影响
- Author:
Bing WU
1
;
Chunyan DU
;
Hao ZHANG
;
Wei WANG
Author Information
1. 锦州医科大学研究生培养基地（中国人民解放军火箭军特色医学中心麻醉科），北京 100088
- Publication Type:Journal Article
- Keywords:
Obesity;
Laparoscopic sleeve gastrectomy;
Lung protective ventilation strategy;
Multi-modal analgesia
- From:
Journal of Chinese Physician
2025;27(2):230-235
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of lung protective ventilation strategy (LPVS) combined with multimodal analgesia (MMA) on the quality of recovery after laparoscopic sleeve gastrectomy (LSG) in obese patients.Methods:A total of 270 obese patients with LSG from the Chinese People′s Liberation Army Rocket Army Characteristic Medical Center and the Beijing Enden Hospital from February 2022 to October 2023 were included. The patients were divided into 3 groups with 90 cases in each group by random number table method. Among them, the traditional group used traditional ventilation mode combined with postoperative controlled intravenous analgesia. MMA group was treated with traditional ventilation mode combined with MMA. LPVS+ MMA group was combined with LPVS and MMA. The occurrence of postoperative pulmonary complications (PPC), resting visual analog scale (VAS) scores, the number of effective patient-controlled analgesia (PCA) compressions, the dosage of sufentanil for analgesia pump, gastrointestinal ventilation time, and the incidence of postoperative nausea and vomiting were observed and compared among the three groups within 3 days after surgery.Results:Incidence of PPC in the LPVS+ MMA group [15.6%(14/90)] was lower than that of the traditional group [37.8%(34/90), P=0.001] and the MMA group [36.7%(33/90), P=0.002]. The effective times of PCA pump and the total amount of sufentanil analgesic pump used in the LPVS+ MMA group and the MMA group were significantly lower than those in the traditional group (all P<0.05). The incidence of postoperative nausea and vomiting in the LPVS+ MMA group was significantly lower than that in the traditional group ( P<0.05). The gastrointestinal ventilation time of the MMA group and the LPVS+ MMA group was significantly better than that of the traditional group (all P<0.05). The VAS scores of the LPVS+ MMA group and the MMA group were lower than those of the traditional group (mean P<0.001), and there was no statistically significant difference between the VAS scores of the three groups (all P>0.05). Conclusions:Compared with traditional ventilation mode combined with postoperative intravenous analgesia, LPVS combined with MMA can reduce the pulmonary complications after LSG in obese patients, reduce the use of opioids, improve postoperative analgesia, reduce the incidence of postoperative nausea and vomiting, and accelerate the recovery of gastrointestinal function.
