纳布啡联合罗哌卡因腹横肌平面阻滞对腹腔镜下全子宫切除术患者的影响

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中图分类号：R614 文献标志码：A DOI：10.3969/j.issn.1003-1383.2025.11.006

【Abstract】ObjectiveToinvestigate theefectsof nalbuphinecombined with ropivacaine transversus abdominis plane block（TAPB）onstressresponse，inflammatoryreactions，postoperativeanalgesia，andadversereactions in patients undergoinglaparoscopic total hysterectomy.MethodsAtotal of6Opatients who underwent laparoscopic total hysterectomy atthe AfiliatedHospitalofYoujiangMedicalUniversityforNationalitiesbetwnJanuary2022andJanuary2O23wererandomly divided into group A（ropivacaine TAPB， n=30 ）and group B（nalbuphine combined with ropivacaine TAPB， n=30 ）. And then，intraoperative stressindicators（norepinephrine［NE]andcortisolCor]），inflammatoryindicators（C-reactiveprotein[CRP]），dosageof anestheticdrugs（propofolandremifentanil），postoperative visualanalogscale（VAS）and sufentanil dosage at2，6，12，and24hoursaftersurgery，aswellastheincidenceofadversereactions between twogroupswere compared.ResultsThere wereno statistically significant diferences in baselineNE，Corand CRP levels betweenthe two groups （ P>0.05 ）. Compared with the group A，the group B showed a more significant decrease in intraoperative NE and Cor levels （ P -values for inter group and time interaction were 0，006 and 0，016 ，respectively），while there was no statistically significant difference in CRP levels between the groups （ P=0.l85 ）.In the group B，propofol and remifentanil doses showed significant reduction （ P<0.05 ）.Postoperatively，VAS scores and sufentanil doses at all time points demonstrated significant decreases （ P<0. 05 ）.There was no significant difference in the incidence of adverse reactions between groups （ P>0.05 ）.ConclusionNalbuphine combined with ropivacaine TAPB in laparoscopic total hysterectomy can effectively llviatepatients‘stressreactions，educe thedosageofanestheticdrugs，enhancepostoperativeanalgesicefects，without increasingtherisk of adversereactions.

【Keywords】nalbuphine；transversus abdominis plane block（TAPB）；laparoscopic total hysterectomy；postoperative analgesia；stress response

子宫切除术是继剖宫产术后居全球第二位的妇科常见手术。（剩余10948字）