Application Of Butofenol Combine Ropivacaine In The Laparoscopic Exploration Surgery

BackgroundInfertility is a common gynecological disease,which has been on the rise in recent years.Infertility refers to the fact that couples have a normal sex life and have not taken any contraceptive measures in one year without a pregnancy.The laparoscopic?hysteroscopic?methylene blue hydrotubation is considered the‘golden standard'for diagnosing oviduct obstruction which can conduct examination and be used to provide therapy at the same time.With the concept of comfortable medical service gradually becoming more and more popular,people has gradually paid more attention to the concept of enhanced recovery after surgery.Laparoscopic surgery is favored by more and more clinicians and patients with its obvious advantages such as small trauma and quick recovery.Compared with traditional open surgery,laparoscopic postoperative pain is in a lesser degree and short duration,often neglected by people.But there were reports that about 65%of the patients suffered moderate pain after laparoscopic cholecystectomy,and 23%suffered severe pain,and 25%of patients had nausea and vomiting after surgery.Therefore,it is of great significance to use appropriate treatment to alleviate patients'pain after surgery,reduce postoperative complications and promote postoperative recovery.During the day,patients are hospitalized for a short time,and traditional postoperative analgesia?intravenous analgesia,epidural analgesia?is expensive,complicated and costly.NSAIDs drugs,which block the peripheral pain signal transmission,are often used to preemptive analgesia.However,its analgesic effect is weak,and its synergistic effect is slight with opioid analgesics,and its use is restricted by many contraindications and complications.Butofenol is a mixed opioid receptor agonist,which can effectively relieve the visceral pain during abdominal surgery.Low concentration ropivacaine analgesia only for the motor nerve block,can relieve 6 h acute incision pain postoperatively in patients with significantly,and effectively prevent the happening of the chronic pain syndrome.This experiment aims to explore the role of the pain management of ERAS in the general anesthesia of the gynecological laparoscopic surgery with infertility.Methods90 patients?ASA I^II?were randomly divided into the B,R,B+R group?n=30?,which were analyzed in the study.All the patients in the three groups were general anesthesia.Butorphanol 1 mg was given before anesthesia induction in group B by intravenous injection;R group 0.20%ropivacaine infiltration step by step before sewing leather with a dose of 5 ml for a incision;B+R group before anesthesia induction butorphanol 1 mg intravenous injection,sewing leather 0.20%ropivacaine infiltration step by step before sewing leather with a dose of 5 ml for a incision.Butorphanol 1 mg was used to by intramuscular injection relieve the pain and maintain VAS score less than 4.Record compare the three groups of patients at the 1 hour after the surgery?T₁?,3h after the surgery?T₂?,6 h after the surgery?T₃?,12 h?T₄?and 24 h?T₅?patients with three groups of VAS score;The number of patients accepting rescue analgesia in the five periods;Postoperative nausea and vomiting,shoulder pain,dizziness and headache,and postoperative pain and overall satisfaction were investigated.ResultsThere was no significant differences in age,weight,and the time of operation among the three groups?P>0.05?;Compared with group B,the wake time,laryngeal mask extraction time and EA were significantly reduced in group B+R?P<0.05?;Compared with group B,VAS score of group R and group B+R significantly decreased at T₂,T₃,T₄ and T₅?P<0.05?.Compared with group R,the VAS score of group B+R was significantly different at T₃ and T₄?P<0.05?.Compared with the group B,the number of additional times of group R and group B+R significantly decreased at 3 h,3 h⁶ h after surgery,and the difference was statistically significant?P<0.05?.Compared to the control group,the incidence of nausea and vomiting in group B,group R and group B+R decreased,showing a statistically significant difference?P<0.05?.Compared to group B,the incidence of nausea and vomiting was significantly decreased in group B+R,and the satisfaction of pain control was significantly increased?P<0.05?.Compared with group R,the incidence of nausea and vomiting was significantly decreased in group B+R,and the satisfaction of pain control was increased,showing a statistically significant difference?P<0.05?.Compared to the control group and the R group,the incidence of shoulder pain in the B+R group decreased,showing a statistically significant difference?P<0.05?.Conclusion1.Under the guidance of multimodal analgesia of ERAS,butorphanol analgesic combined ropivacaine incision infiltration can effectively relieve postoperative pain patients and extend the time of postoperative analgesia in the laparoscopic exploration of infertility patients.2.Compared to a single analgesic model,butorphanol combined with ropivacaine can reduce the number of remediation times and reduce postoperative complications.