A comparative study of multi-modal analgesic regimen versus traditional analgesic regimen in laparoscopic sur-gery for benign gynecological diseases under Enhanced Recovery After Surgery(ERAS)model

ZHANG Jing; XIA Yu; LU Xi; LI Yi-lin; SUN Xin-ping; MAO Wen-juan; WANG Yong-jun

doi:10.19538/j.fk2024060117

Abstract：Objective To compare the effectiveness of multi-modal analgesic regimen versus traditional analgesic regli-men under the Enhanced Recovery After Surgery(ERAS)in laparoscopic surgery for benign gynecological diseases.Methods A cohort of 291 female patients diagnosed with benign gynecological diseases were enrolled from Beijing Ji-shuitan Hospital affiliated with Capital Medical University from March 2022 to August 2023 and Peking University Inter-national Hospital from September 2020 to July 2021.The patients were divided into three groups(adnexal group,uterine group and total hysterectomy group)based on the type of surgery using block randomization.Within each block,patients were randomly assigned to either the study group or the control group at a 1:1 ratio.Both groups were administered iden-tical anesthesia induction and intraoperative nonsteroidal anti-inflammatory drugs(NSAIDs)for prophylactic analgesia.The study group received pre-incisional and postoperative ropivacaine for local infiltration anesthesia,in addition to postoperative NSAIDs for prophylactic analgesia.The control group did not receive local infiltration anesthesia and did not receive routine analgesia postoperatively(unless requested by the patient,in which self-controlled analgesia pump was provided).Postoperative Visual Analogue Scale/Score(VAS)and the incidence of postoperative nausea and vomiting(PONV)were evaluated at 2h,6h,24h,and 48h.Results The study group exhibited statistically significant re-ductions in VAS scores at the same condition 6h and at static state 24h postoperatively compared to the control group(P＜0.05),and the VAS scores at the same condi-tion 2h、6h and at static state 24h postoperatively were significantly lower in the study group compared to patients in the control group who received analgesia pump(P＜0.05).The incidence of nausea(35.2％vs.19.6％)and vomiting(27.8％vs.11.2％)was higher in the control group using analgesia pump compared to the study group(P＜0.05).Conclusion In laparoscopic surgical interventions for benign gynecological diseases,multi-modal analgesic under the ERAS para-digm demonstrated superior analgesic efficacy and patient comfort relative to traditional analgesic regeien.The first 24 hours postoperatively represent the optimal window for pain management.