The Application And Effect Of Intraoperative Compound Analgesia In Transabdominal Cervical Cancer Surgery

Objective: To investigate the effect of multimode analgesia in the perioperative period of transabdominal cervical cancer.Methods: A total of 109 patients who underwent abdominal extensive hysterectomy,and pelvic lymphadenectomy at Shengjing Hospital of China Medical University from November 2017 to November 2019 were selected.Among them,there were 26 cases in the local block group(group P),29 cases in the transverse abdominal muscle block group(TAP)(group M),24 cases in the local block plus transverse abdominal muscle block group(PM group),and 30 cases in the control group(group C).Patients in each group were compared at 0 hours,2 hours,6 hours,12 hours,24 hours,36 hours,and 48 hours about the degree of pain after surgery,the intraoperative dose of remifentanil,postoperative exhaust time,abdominal drainage removal time,the length of hospital stay after surgery and hospitalization expenses were compared too.Results: There was no significant difference between the four groups in terms of age,weight,anesthesia time,operation time,and intraoperative blood loss(P>0.05).There was a significant difference in four groups at 0,2 and 6 hours postoperatively on the VAS scores(P<0.05).The VAS scores of the three experimental groups were smaller than the control group,but the pairwise comparison between the three experimental groups on VAS scores was not significant(P>0.05).For each group there were statistically different on VAS scores at 12 hours postoperatively(P<0.05).Among them,the local block and abdominal transverse muscle plane block group had the lowest VAS score at 12 hours after operation,and the control group had the highest score.The score of the transverse abdominal muscle plane block group was slightly higher than that of the local block and the transverse abdominal muscle block group scores higher than the transverse abdominal muscle plane block group.At 24 hours?36 hours and 48 hours after surgery,there was no significant difference in the VAS scores of patients in each group(P>0.05).There was a significant difference in the use of remifentanil in the patients in each group(P<0.05).The local block plus transverse abdominal plane block group used the least amount of remifentanil in the operation,and the transverse abdominal plane block group Slightlymore,the local block group was more than the above two groups.The control group used the most dose of remifentanil during the operation,and the local block plus the transverse abdominal muscle block and the transverse abdominal muscle block were used in a pairwise comparison between groups.There was no statistical difference between the groups,and there was no statistical difference between the control group and the local block group.There were no significant differences in emissions,abdominal drainage and removal time,postoperative hospital stay,and total hospital costs(P>0.05).Conclusion: According to this clinical study,it can be concluded that on the basis of prophylactic analgesia given with NSAIDs 30 min before surgery,intraoperative use of non-opioid or short-acting opioid anesthetics;postoperative continued use of acetaminophen or NSAIDs,local intraoperative block and ultrasound-guided plane block of the transverse abdominis have significant positive effects on early postoperative analgesia,and can reduce the amount of intraoperative fentanyl drugs.However,other indicators such as postoperative exhaust and extraction time of abdominal drainage still need further clinical observation.