Multimodal analgesia in laparoscopic splenectomy and pericardial devascularization around perioperative period / 中国现代普通外科进展

ABSTRACT

Objective:To discuss the clinical reference value of multimodal analgesia in laparoscopic splenectomy and pericardial devascularization around perioperative period (LS+PDA) based on FTS (fast track surgery) concept.Methods:Previously from September 2015 and March 2017,69 patients with portal hypertension were given LS+PDA,37 patients were given traditional perioperative analgesia program (named traditional group),other 32 patients were given multimodal analgesia around perioperative period (named FTS group).The degree of postoperative pain,ambulation time,eating time,anal exhaust time,gastric tube decompression,indwelling time,postoperative 72 hours sleep time,postoperative hospital stay,postoperative adverse reactions were compared between two groups.Results:When operation finished,1,4,8,12,24,48 and 72 hours,pain digital assessment scale of FTS group was significantly lower than traditional group (P＜0.05).FTS group's ambulation,feeding,anal exhaust,gastric tube indwelling and postoperative hospital time all were significantly shorter than traditional group (P＜0.01),its sleeping time after 72 hours was obviously longer than traditional group (P＜0.01).Nausea and vomiting,regurgitation and gastrointestinal reactions,breathing difficulties,splenopyretic incidence of FTS group was significantly lower than traditional group (P＜0.05),and other adverse reactions were no statistical significance between two groups.The all approval rate of postoperative analgesia in FTS group was significantly higher than that in traditional group (P＜0.05).Conclusion:Multimodal analgesia in LS+PDA based on FTS concept has been safe and effective,which nearly can achieve painless surgery.