艾司氯胺酮复合腹横肌平面阻滞对腹腔镜妇科手术后患者恶心呕吐及疼痛的影响

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EffectsofEsketamine CombinedwithTransversusAbdominalPlane Block onNausea，Vomiting and PaininPatientsafterLaparoscopic Gynecological Surgery/HONGXiu.//Medical Innovationof China， 2025，22（18）：054-058

[Abstract]Objective：To investigate the efects of Esketamine combined with transversus abdominal plane block （TAPB）on nausea， vomiting and pain in patients after laparoscopic gynecological surgery.Method： The clinical dataof 88 patients whounderwentlaparoscopic gynecologicalsurgeryinFujianMedicalUniversityAffiliated Union Hospital from February 2O22 to February 2O24 were analyzed retrospectively.Thepatients weredivided into two groups according to different analgesic methods： the control group （ n =43，received TAPB analgesia） and the observation group （ n =45，received multimodal analgesia with Esketamine combined with TAPB）. The occurrence of nausea and vomiting，pain condition，postoperative recovery condition，dosage of anesthetic drugs and patient satisfaction werecompared between the two groups.Result： Compared with the control group，the incidence of nausea and vomiting in the observation group was lower，the diffrence was statistically significant （ P <0.05）. The visual analogue scale （VAS） scores of the observation group in resting and coughing state at T，T2，' 13 and T4 were lower than those of the control group，the extubation time，the stay time in postanesthesiacareunit and the hospital stay wereshorter thanthoseofthecontrol group，thefirst imeto getoutofbedandthethefirst timeofexhaust were earlier hanthose of thecontrol group，the dosages of Propofol and Remifentanil during theoperation were less than those in the control group，the differences were statistically significant （ P <0.05）. Compared with the control group， satisfaction of the patient inthe observation group was higher，the diffrence was statistically significant （ P <0.05）.

Conclusion： Esketamine combined with TAPB can effectively reduce the incidence of nausea and vomiting in patients afterlaparoscopic gynecological surgery，alleviate the degree of pain，reduce the dosage of anesthetic drugs， promote postoperative recovery，and improve satisfaction of the patients.

随着医学技术迅速发展，微创手术逐渐应用于临床，腹腔镜手术作为典型微创术式，在妇科疾病诊疗中具有重要作用[1-2]。（剩余6360字）