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| Analgesia effect of ultrasound-guided transverse abdominis plane block combined with general anesthesia during laparoscopic total hysterectomy |
| 1. Civil Aviation General Hospital, Beijing, 100123; 2.Beijing Renhe Hospital |
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Abstract To observe the influence of ultrasound-guided transverse abdominis plane (TAP) block combined with general anesthesia during laparoscopic total hysterectomy on their postoperative analgesia and restlessness during resuscitation, and their cognitive function. Methods: 40 women who wanted elective laparoscopic total hysterectomy were randomly divided into study group and control group. The women in both groups were given bilateral TAP block by ultrasound guidance after anesthesia induction, and the women in the study group were given 0.33% ropivacaine hydrochloride 30mL injected, while the women in the control group were given equal volume normal saline injected. Intraoperative dosage of fentanyl, postoperative recovery time, spontaneous breathing recovery time, and incidence of restlessness during resuscitation of women in both groups were recorded. VAS analgesia score at 2h, 12h, and 24h after surgery, as well as postoperative and the score of postoperative cognitive function（MMSE）were evaluated and recorded. Results: The dosage of intraoperative fentanyl, the recovery time of spontaneous breathing, the postoperative recovery time, and the incidence of restlessness during resuscitation of women in the study group were 253.6±72.8 g, 9.3±1.7min, 6.3±0.9min, and 15.0%, respectively, which were all significant lower than those of women in the control group. The VAS scores of women at 2h and 12h after the operation in the study group were also significant lower than those of women in the control group (all P <0.05). There were no significant difference in preoperative MMSE score and postoperative independent breathing recovery time of women between the two groups (P>0.05). After operation, the MMSE score of women at 12h and 48h after the in the two groups had significantly decreased, and that in the study group was significant higher than that of women in the control (P <0.05). Conclusion: Compared with intravenous general anesthesia alone, TAP block combined with general anesthesia can significantly reduced fentanyl dosage during laparoscopic total hysterectomy, can improve the early postoperative recovery and analgesia effect, reduce the incidence of restlessness during awakening, improve the quality of awakening and improve cognitive function, which can help to accelerate the implementation of the concept of rehabilitation of surgery.
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