Abstract
This paper aimed to study the application of local anesthetics combined with transversus abdominis plane (TAP) block in gynecological laparoscopy (GLS) surgery during perioperative period under the guidance of ultrasound image enhanced by the wavelet transform image enhancement (WTIE) algorithm. 56 patients who underwent GLS surgery in hospital were selected and classified as the infiltrating group and block group. The puncture needle was guided by ultrasound images under WTIE algorithm, and 0.375% ropivacaine was adopted to block TAP. The results showed that the dosage of propofol in the infiltrating group (313.23 ± 19.67 mg) was remarkably inferior to the infiltrating group (377.67 ± 21.56 mg) (P < 0.05). The hospitalization time of patients in the infiltrating group (2.14 ± 0.18 days) was obviously shorter than that of the infiltrating group (3.23 ± 0.27 days) (P < 0.05). 3 h, 6 h, and 12 h after the operation, the visual analogue scores (3.82 ± 1.58 points, 2.97 ± 1.53 points, and 1.38 ± 0.57 points) of the patients in the infiltration group were considerably higher than the infiltrating group (2.31 ± 1.46 points, 1.06 ± 1.28 points, and 0.95 ± 0.43 points) (P < 0.05). 3 h, 6 h, and 12 h after the operation, the number of patients in the infiltrating group who used tramadol for salvage analgesia (2 cases, 1 case, and 1 case) was notably less than that in the infiltration group (9 cases, 7 cases, and 3 cases) (P < 0.05). In short, local anesthetics combined with TAP block can reduce postoperative VAS score and postoperative nausea and vomiting (PONV) score, which also reduced the incidence of postoperative analgesia.
Highlights
Gynecological laparoscopy has been widely adopted in clinical treatment because of its advantages of small trauma, light pain, and quick recovery [1]
All patients were classified as grade I and grade II according to American Society of Anesthesiologists (ASA). e random number table method was utilized to divide the patients into the infiltrating group (n 28) and block group (n 28). e study had been approved by the Medical Ethics Committee of Hospital, and the patients and their families understood the situation of the study and signed the informed consent forms
Statistics of General Information of Patients. ere was no considerable difference in the average age, average weight, average height, and ASA classification results between the two groups (P > 0.05) (Figure 2). e gynecological laparoscopy (GLS) surgery received by the two groups of patients included ovarian cyst removal, hysteromyoma removal, and subtotal hysterectomy
Summary
Gynecological laparoscopy has been widely adopted in clinical treatment because of its advantages of small trauma, light pain, and quick recovery [1]. Due to the different physiques of the patients, the pain is still unbearable. After GLS, patient-controlled intravenous analgesia is commonly adopted, and the analgesic effect is very significant. It causes more side effects, and it is prone to adverse symptoms such as respiratory depression, nausea, vomiting, and skin itching [2]. Erefore, the pain of the skin, muscles, and peritoneum of the front abdomen is weakened, and a relatively ideal abdominal wall analgesic effect is achieved [3]. The application of TAP block in postoperative analgesia has gradually increased. Ping-Chen et al [4] found that different drug concentrations had a greater impact on laparoscopic surgery, so it was urgent to determine the optimal drug concentration
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