Effect Of Oxycodone Combined With Local Infiltration Of Ropivacaine On Rapid Recovery In Patients Undergoing Gynecological Laparoscopic Operation

Objective:To observe the effects of oxycodone intravenous injection combined with local infiltration of ropivacaine on the enhanced recovery after gynecological laparoscopy surgery.Method:60 patients from the Second Hospital of Jilin University who were scheduled to undergo elective gynaecological laparoscopic surgery under general anesthesia from January 2021 to December 2021 were enrolled in the study.The patients were randomly divided into groups RO（ropivacaine+oxycodone）,PCIA（PCIA）and C（control）,20 cases in each group.Three groups of patients underwent tracheal intubation to ensure ventilation after routine induction.The patients in group RO were intravenously injected with oxycodone 0.05 mg/kg 20 minutes before the end of the surgery,and tinfiltrated locally with 0.375% ropivacaine after closing the pneumoperitoneum.Patients in group PCIA were connected to PCIA after surgery（drug preparation: 1 ug/kg sufentanil was combined with 12.5mg dolasetron.The mixture was produced with 0.9% normal saline in 100 ml,the background infusion rate was 2ml/h,the single press dose was 1ml and the locking time was 15min）.Patients in group C was not treated.The general condition,operation time,operation method,awake time,tracheal extubation time,the occurrence of cough and Ramsay score after tracheal extubation were recorded.The postoperative VAS scores was recorded at 5min after tracheal extubation and 2h,6h,8h,10 h,12h,24 h and 48 h after the operation.If the VAS score of the patients was over 4,5 ug sufentanil was used and the number of patients who used sufentanil was recorded.The satisfaction score for anesthesia,time to get out of bed for the first time,exhaust time,hospitalization time,hospitalization expenses,and the occurrence of adverse reactions were recorded.Results:1.There was no statistical difference in the general condition and clinical data among the three groups（P>0.05）.2.There was no significant difference in the recovery time,extubation time and Ramsay score among the three groups（P>0.05）.Compared with the group RO,the patients in group PCIA and group C had higher incidence of choking reaction and the VAS score at T0（P<0.05）.3.Compared with the group C,the group RO and PCIA had lower VAS scores at T1,T2,T3,and T4（P<0.05）.There were more cases of rescue analgesia in group C（P<0.05）.4.Compared with the group PCIA,the group RO had lower incidence of dizziness,nausea and vomiting（P<0.05）.5.Compared with the group RO,the anesthesia satisfaction score of group PCIA and C was significantly decreacesd（P<0.05）.6.The time to get out of bed and exhaust time in group RO were significantly earlier than those in group PCIA and group C（P<0.05）.The average hospitalization time of group PCIA and group C was significantly longer than that of group RO（P<0.05）.The average hospitalization cost of group PCIA was significantly higher than that of group RO（P<0.05）.Conclusion:Oxycodone intravenous injection combined with local infiltration of ropivacaine can improve postoperative analgesia in gynecological laparoscopic patients,accelerate postoperative recovery,and provide clinical reference.