Evaluation Of The Effect Of Low Dose Neostigmine On The Recovery Of Gastrointestinal Function After Gynecological Laparoscopic Surgery

Objective:Objective To evaluate the effect of low dose neostigmine on the recovery of gastrointestinal function after gynecological laparoscopic surgery.Methods:Sixty patients who underwent laparoscopic gynecological surgery under general anesthesia combined with quadratus lumborum nerve block,aged30-55 years,18.5 kg/m2≤BMI≤27.9kg/m2,and the duration of operation < 3hours,were selected as the research objects.ASA was Grade I-II.The research has been approved by the Ethics Committee and the patients have informed consent.The selected subjects were randomly divided into two groups,30 cases in each group: neostigmine group(N group)received intravenous neostigmine 0.01mg/kg+ atropine 0.005mg/kg after surgery.The control group(group C)was not given neostigmine,and both groups were given the same patient-controlled intravenous analgesia pump after operation.The analgesics included 1ug/kg sufentanil +200mg flurbiprofen axetil +1ug/kg dexmedetomidine +10mg tropisetron,diluted to 100 ml with normal saline,and the background infusion volume was controlled at 2ml/h,and the amount was increased by 0.5ml each time when pressing,and locked for 15 min.After the operation,the first exhaust time and the first time to get out of bed were observed,and the VAS scores of the patients at 6 hours,12 hours,24 hours and 48 hours after the operation were evaluated,and the adverse reaction rate of the patients was recorded.Results:1.The general situation of patients in the two groups mainly involves body weight,age,BMI,ASA grade,operation duration,etc.There is no statistical difference between the above data(P>0.05).2.There was a statistical difference in the first exhaust time between the two groups(P < 0.05),and the first exhaust time in group N(20.17(19.54,20.58))was significantly shorter than that in group C(27.54 0.89).The first defecation time between the two groups was statistically different(P < 0.05),and the first defecation time in group N(27.71(26.83,28.02))was significantly shorter than that in group C(35.30 0.92).3.There was a statistical difference in the recovery time of bowel sounds between the two groups(P < 0.05),and the recovery time of bowel sounds in group N(10.93 1.08)h was significantly shorter than that in group C(18.060.63)h.4.There was no significant difference in VAS scores between the two groups at 6h,12 h,24h and 48 h after surgery(P > 0.05).5.There was no significant difference in the time of first postoperative operation between the two groups(P > 0.05).6.There was no significant difference in heart rate between the two groups after medication(P > 0.05).7.There were some adverse events and complications after operation in the two groups,mainly including delayed awakening,respiratory depression,nausea and vomiting,and there was no statistical difference between the two groups(P>0.05).Conclusions:The application of low dose neostigmine in gynecological laparoscopic surgery can obviously improve the recovery of gastrointestinal function after operation.It effectively shortens the recovery time of postoperative bowel sounds,the time of first exhaust and defecation,shortens the recovery time,and improves the patient’s medical experience,which is worth popularizing in clinic.