Comparison Of Rectal Abdominis Sheath Block Combined With Intravenous Analgesia Pump And Continuous Epidural Block On Analgesia After Laparoscopic Hepatectomy

Objective: To compare the application of rectus abdominis sheath block combined with PCIA and epidural block combined with PCEA in laparoscopic hepatectomy to observe the postoperative analges ic effect,postoperative recovery time and the inc idence of postoperative adverse reactions.Safer and more effective analgesic methods.Methods: 60 patients who underwent laparoscopic hepatectomy at the First Affiliated Hospital of Guangxi Medical Univers ity were selected and randomly divided into two groups: rectus sheath block combined with PCIA group(group R)and epidural res istance There were 30 cases of stagnation combined with PCEA group(group E).Before the induction of anesthesia in group R,ultrasound-guided bilateral rectus abdominis sheath block was performed,then TCI target-controlled general anesthesia induction and anesthes ia maintenance were performed,and a PCIA pump was connected after surgery.Group E was given epidural puncture and catheterization before anesthesia induction.General anesthesia induction and anesthesia were maintained as in group R.Local epidural anesthesia was given continuously during operation,and PCEA pump was connected after operation.Mainly record the pain VAS scores at 4,8,12,24,36,and 48 hours after surgery,and record the actual analges ic pump bolus times,effective analgesic pump Bolus times,incidence of adverse reactions,gastrointestinal function recovery time,urinary catheter extraction Time out,early activity time.Results: There was no statistically s ignificant difference in the inc idence of pain VAS scores,bolus times,gastrointestinal function recovery time,nausea and vomiting,skin itching,and headache at each time period between the two groups(P>0.05).The urinary catheter extraction time in group R(50.47±18.51h)was shorter than that in group E(60.53±19.98 h),the early activity time in group R(32.8±11.59 h)was shorter than that in group E(50.77±12.80 h),and group R The incidence of hypotension(0 cases)was lower than that of group E[6 cases(20%)],the difference was statistically significant(P<0.05).Conclusion: Ultrasound-guided rectus sheath block combined with PCIA compared with epidural block combined with PCEA has similar analges ic effect after laparoscopic hepatectomy,but can shorten the postoperative recovery time and reduce the incidence of postoperative adverse reactions.