关键词:

子宫肌瘤, 经皮神经电刺激, 加速康复外科, 腹腔镜全子宫切除术, 镇痛

Abstract:

Objective To investigate the analgesic effect of multi⁃mode percutaneous electrical nerve stim⁃ ulation（TENS）combined with multi ⁃mode analgesia of enhanced recovery after surgery（ERAS）in laparoscopic total hysterectomy. Methods Sixty patients who planned to undergo laparoscopic total hysterectomy were randomly divided into ERAS group（n=30）and ERAS + TENS group（n = 30）. Visual analogue scale（VAS）and Ramsay sedation score were compared between two groups at 4 h，8 h，16 h and 24 h after surgery. Serum β⁃endorphin lev⁃ els were detected before anesthesia induction，30 min after operation，and when patients were awake after surgery. The amount of intraoperative blood loss，operation time，intraoperative anesthetic dosage，nausea and vomiting in postoperative 48 h，postoperative exhaust time and postoperative hospital stay were compared between the two groups. Results Compared with ERAS group，the VAS score decreased at 16 h after surgery，and Ramsay seda⁃ tion score increased at 8 h and 16 h after surgery in ERAS+TENS group（P < 0.05）. The levels of β⁃endorphin in ERAS+TENS group were significantly higher than those in ERAS+TENS group at 30 min after operation and at post⁃ operative wakefulness（P < 0.05）. There were no significant differences in intraoperative blood loss，operation du⁃ ration，postoperative hospital stay，postoperative exhaust time，dosage of propofol and remifentanil，and incidence of nausea and vomiting between the two groups（P > 0.05）. But the incidence of non⁃incision pain was significantly decreased in ERAS + TENS group（P < 0.05）. Conclusion TENS combined with ERAS multi ⁃mode analgesia could reduce postoperative pain and improve sedation comfort in patients with laparoscopic total hysterectomy，but could not reduce the amount of opioids.

Key words:

fibroid, transcutaneous electrical nerve stimulation, enhanced recovery after surgery, laparoscopic total hysterectomy, analgesia