帕瑞昔布钠预防性镇痛联合超声引导下腹横肌平面阻滞用于妇科全子宫切除术后镇痛的效果

doi:10.3969/j.issn.1006-6233.2022.04.023

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Abstract Objective:To investigate the effect of ultrasound-guided transverse abdominal plane block (TAPB) combined with parecoxib sodium (PCX) for postoperative analgesia after gynaecological total hysterectomy and the effect on pain mediators. Methods:Eighty patients who underwent elective transabdominal total hysterectomy in our hospital from 07/2018 to 11/2021 were selected and divided into two groups of 40 patients each by simple random grouping, with the control group given TAPB compound general anesthesia and the study group given PCX on top of the control group. anesthesia was observed in both groups, and patients' levels of prostaglandin E2 (PGE2), substance P (SP), β-endorphin (β-EP), pentraxin (5-HT) and other pain mediators were measured at admission (preoperative), 6h postoperative, 12h postoperative, and 24h postoperative. (PGE2), substance P (SP), β-endorphin (β-EP), pentraxin (5-HT) and other pain mediators at the time of admission (preoperative); 6h postoperative, 12h postoperative and 24h postoperative, and pain at the time of discharge; 6h postoperative, 12h postoperative and 24h postoperative was assessed using the comfort score (BCS) and visual analogue scale (VAS).Results: In the study group, the dosage of remifentanil was significantly less than that of the control group, and the time for recovery of spontaneous breathing, awakening, first anal discharge and bed movement was significantly shorter than that of the control group (P<0.05); the levels of PGE2, SP, β-EP and 5-HT gradually increased after surgery and gradually decreased after reaching the peak at 6h postoperatively, and the levels of PGE2, SP and 5-HT in the study group were significantly lower than those in the control group at 6h, 12h and 24h postoperatively (P<0.05). The VSA score gradually increased after leaving the room, and the levels of PGE2, SP and 5-HT in the study group were significantly lower than those in the control group at 6h, 12h and 24h postoperatively (P<0.05); the BCS score gradually decreased after surgery, and the levels of PGE2, SP and 5-HT in the study group were significantly higher than those in the control group at 6h, 12h and 24h postoperatively (P<0.05); the BCS score gradually decreased after surgery, and the levels of β-EP in the study group were significantly higher than those in the control group at 6h, 12h and 24h postoperatively (P<0.05). The incidence of adverse reactions was not statistically different between the two groups (P>0.05).Conclusion: The combined application of PCX and TAPB in transabdominal total hysterectomy can effectively reduce the release of pain mediators, relieve patients' postoperative pain and improve their postoperative comfort with good safety.

Key words： Ultrasound guided transversus abdominis plane block Parecoxib sodium Total hysterectomy Analgesia Pain mediator

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	XIE Hong
	DENG Guokui
	HU Bo
	et al

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XIE Hong,DENG Guokui,HU Bo, et al. Effectiveness of Parecoxib Sodium Prophylactic Analgesia Combined with Ultrasound-Fuided Transversus Abdominis Plane Block for Postoperative Analgesia After Gynecological Total Hysterectomy[J]. HeBei Med, 2022, 28(4): 644-648.

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2022.04.023 OR http://www.hbyxzzs.cn/EN/Y2022/V28/I4/644

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