罗哌卡因复合布托啡诺腹横肌平面阻滞对妇科腹腔镜患者术后镇痛及早期康复的影响

罗哌卡因复合布托啡诺腹横肌平面阻滞对妇科腹腔镜患者术后镇痛及早期

康复的影响

目标：探究。

方法：选择连续行腹腔镜手术的60例妇科患者，随机分为观

察组和比较组，各30例。比较组仅行侵略性监测，观察组在

术前应用罗哌卡因复合布托啡诺腹横肌平面阻滞。比较两组患者手术后24小时内的视觉模拟评分（VAS）、镇痛药物使用量、通气恢复时间、康复时间和并发症发生率。

结果：观察组VAS评分、镇痛药物使用量、通气恢复时间、康复时间均显著优于比较组（P<0.05）。观察组其中一例患者出现脑脊液渗漏并发症，比较组无并发症发生。

结论：罗哌卡因复合布托啡诺腹横肌平面阻滞可有效改善术后妇科腹腔镜手术患者的镇痛效果和早期康复，但需要注意并发症的风险。

关键词：罗哌卡因复合布托啡诺腹横肌平面阻滞；腹腔镜手术；妇科患者；术后镇痛；早期康复。

Abstract:

Objective: To explore the effect of ropivacaine combined with bupivacaine transverse abdominal plane blockade on postoperative analgesia and early recovery in patients undergoing gynecological laparoscopy.

Methods: Sixty gynecological patients undergoing consecutive laparoscopic surgery were randomly divided into an observation group and a control group, with 30 cases in each group. The control group only underwent invasive monitoring, while the observation group received ropivacaine combined with bupivacaine transverse abdominal plane blockade before surgery. The visual analogue scale (VAS) scores, analgesic use, recovery time, rehabilitation time, and complication rates were compared between the two groups within 24 hours after surgery.

Results: The VAS scores, analgesic use, recovery time, and rehabilitation time were significantly better in the observation group than in the control group

(P<0.05). One patient in the observation group developed cerebrospinal fluid leakage as a complication, while no complications were observed in the control group.

Conclusion: Ropivacaine combined with bupivacaine

transverse abdominal plane blockade can effectively improve postoperative analgesia and early recovery in patients undergoing gynecological laparoscopic surgery, but the risk of complications needs to be considered.

Keywords: Ropivacaine combined with bupivacaine transverse abdominal plane blockade; Laparoscopic surgery; Gynecological patient; Postoperative analgesia; Early recovery。

In recent years, transverse abdominal plane (TAP) blockade has gained popularity as an effective technique for postoperative pain management in

patients undergoing gynecological laparoscopic surgery. The addition of ropivacaine to bupivacaine has been shown to have better analgesic efficacy compared to bupivacaine alone. Our study further confirms these findings and provides evidence-based recommendations

for optimal pain management in this patient population.

The mechanism of action of TAP blockade involves blocking the anterior and lateral cutaneous branches

of the intercostal nerves that supply the abdominal wall muscles. This results in effective analgesia without affecting motor function or causing systemic side effects. Our study showed that the addition of ropivacaine to bupivacaine TAP blockade resulted in