Effects Of Continuous Incision Infiltration And Intravenous Analgesia On Analgesic Effect After Pancreaticoduodenectomy

Objective: To investigate the effects of continuous local infiltration of ropivacaine incision and intravenous analgesia on the analgesic effect and adverse reactions after pancreaticoduodenectomy.Methods: A total of 60 patients who underwent open pancreaticoduodenectomy under general anesthesia in Shengjing Hospital Affiliated to China Medical University were randomly divided into two groups according to different postoperative analgesia methods: Group A(venous group,n = 30)was treated with sufentanil 2ug/kg + Ketorolac Tromethamine 2ug/kg + 0.9% normal saline.Group B(local group,n=30)was 0.375% ropivacaine 60ml+0.9% normal saline 100 ml.Observed two group Visual analog pain Score(Visual Analogue Score,VAS)at four points: finish the surgery,6 h,24 h,and 48 h after surgery,postoperative remedial drug using frequency and the duration when using analgesic drugs for the first time,before 1 day,on the first day after operation and the second day level of leukocyte and neutrophil counts,the first time to meal,length of hospital stay and the incidence of adverse reactions.Results: VAS score,time and frequency of first use of remedial drugs were significantly lower in group B than in group A(P<0.05).The white blood cell count and percentage of neutrophils of the two groups in two days after the operation were higher than that of the day before the operation,and the white blood cell count in group B on the second day after the operation was lower than that in group A,with statistically significant differences(P<0.05),while the percentage of neutrophils in the two groups was not significantly different(P>0.05).The first postoperative feeding time and hospitalization time of group B was significantly shorter than that of group A,and the incidence of adverse reactions within 48 hours after the operation was also significantly lower than that of group A(P<0.05).Conclusion:Using ropivacaine continuous local infiltration in pancreaticoduodenal resection,it can give more directly and effectively control to the pain,reduce the dosage of remedies,to extend the time of analgesia,reduce the incidence of adverse reactions,and can indirectly promote the recovery of gastrointestinal function,shorten hospitalization time,accelerate rehabilitation process.