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Objective:To investigate the feasibility and effectiveness of incision subcutaneous porous catheter combined with ropivacaine analgesia in enhanced recovery after laparoscopic gastrointestinal surgery.Methods:The clinical data of 140 patients underwent gastrointestinal surgery from August 2021 to April 2022 in Shanghai Fourth People′s Hospital, School of Medicine, Tongji University were retrospectively analyzed. Among them, 70 patients were given routine postoperative analgesia (control group), and 70 patients were given incision subcutaneous porous catheter combined with ropivacaine analgesia on the basis of routine postoperative analgesia (observation group). The visual analogue score (VAS) 4, 24, 32, 48, 56 and 72 h after operation was evaluated; and the complications of subcutaneous catheterization, incision infection, postoperative nausea vomiting, neurological symptoms, time to extubation, patient satisfaction degree, recovery time of intestinal function and hospital stay were recorded.Results:The VAS 4, 24, 32, 48, 56 and 72 h after operation in observation group was significantly lower than that in control group: 1.000 (- 0.250, 2.250) scores vs. 1.000 (- 1.000, 3.000) scores, 2.000 (1.000, 3.000) scores vs. 4.000 (2.000, 6.000) scores, 1.000 (0.000, 2.000) scores vs. 3.000 (1.000, 5.000) scores, 2.000 (1.000, 3.000) scores vs. 3.000 (1.750, 4.250) scores, (1.100 ± 0.934) scores vs. (2.085 ± 0.943) scores and (0.985 ± 0.842) scores vs. (1.814 ± 0.921) scores, and there was statistical difference ( P<0.05 or <0.01). The recovery time of intestinal function and hospital stay in observation group were significantly shorter than that that in control group: (1.743 ± 0.557) d vs. (2.200 ± 0.714) d and (8.043 ± 1.160) d vs. (8.757 ± 1.221) d, and there were statistical difference ( P<0.01); there were no statistical differences in the rate of incision infection, incidence of postoperative nausea vomiting, time to extubation and patient dissatisfaction rate between two groups ( P>0.05); there were no the complications of subcutaneous catheterization and neurological symptoms in two groups. Conclusions:The incision subcutaneous porous catheter combined with ropivacaine analgesia after laparoscopic gastrointestinal surgery is a safe, effective and feasible method. Multimodal analgesia under enhanced recovery after surgery can increase the postoperative recovery after gastrointestinal operations and shorten the postoperative hospital stay.
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Objectives:To investigate the effect of glutamine on the shape of residual intestine and colon in rats with short bowel syndrome. Methods:23 male Sprague-Dawley rats,underwent a 80% small bowel resection,were randomly divided into three groups:food group(n=8) rats,fed rat chow and water libitum after operation;TPN group(n=8),infused with Gln-supplied TPN;and normal control group.On seventh day after operation,rats were weighted and remaining jejunum、remaining ileum and colon were harvested for histological observation(light microscopy and electron microscopy). Results:There was significant difference in rat average weight between food group and Gln group after operation.Jejunal mucosal villus height(VH) and mucosal thickness(MT) and ileal mucosal VH in food group were significantly increased than those in control group.Jejunal mucosal VH and MT in control group were significantly higher than in TPN group.Ileal mucosal crypt depth(CD) and MT in control group were also significantly higher than in TPN group.Jejunal and ileal mucosal VH、CD and MT in Gln group were significantly higher than in TPN group.Colonic MT in food group was significantly higher than in control group.Colonic MT in Gln group was significantly bigger than in TPN group. Conclusions:After 80% intestinal resection,the remaining intestine can develop the adaptation,but the adaptation is incomplete.TPN therapy can maintain body weight,but only TPN can not result in the adaption.Gln-supplied TPN can stop the remaining itestinal mucosal atrophy,and promote the remaining intestinal adaptation and colonic mucosal hypertrophy.