Effect of transverse abdominal muscle plane block combined with butorphanol on postoperative analgesia and inflammatory response in patients undergoing laparoscopic cholecystectomy

Song Li; Zhong Qing; Ni Lina; Wu Cong; Xia Xuan; Luo Li; Chen Xintang

doi:10.3969/j.issn.1672-8157.2025.03.014

Abstract：Objective To observe the effect of transversus abdominis plane block(TAPB)combined with butorphanol on post-operative analgesia and inflammatory response in patients undergoing laparoscopic cholecystectomy.Methods A total of 108 pa-tients who underwent elective laparoscopic cholecystectomy in the Xinjin District Traditional Chinese Medicine Hospital of Cheng-du from January 2022 to October 2024 were recruited as the research subjects and divided into the observation group(n=54)and the control group(n=54)by the random number table method.The observation group was given 0.25%ropivacaine hydrochloride com-bined with 2 mL of butorphanol combined with TPAB,while the control group was given 0.25%ropivacaine hydrochloride com-bined with 2 mL of normal saline combined with TPAB.The mean arterial pressure and heart rate were compared between the two groups before surgery(T0),at the time of skin incision(T1),at the time of cholecystectomy(T2),and at the end of surgery(T3);the occurrence of complications during the recovery period,recovery time and spontaneous breathing were also observed and compared between the two groups.The pain levels were compared between the two groups at 12,24 and 48 hours after recovery,while the levels of inflammatory factors were compared between the two groups before the surgery and at 48 hours after the surgery.Results The heart rate and mean arterial pressure of the observation group and the control group were respectively(72.78±4.15)times·min-1,(73.66±5.23)times·min-1,(70.27±4.53)times·min-1,(71.42±4.38)times·min-1,(85.63±2.58)mm Hg(1 mm Hg≈0.133 kPa),(83.27±2.18)mm Hg,(82.56±2.71)mm Hg and(79.39±2.43)mm Hg at T1 and T2,lower than(77.32±4.86)times·min-1,(77.51±4.69)times·min-1,(88.71±3.69)mm Hg and(88.34±3.52)mm Hg at T0,but the above indexes of the observation group were high-er than those of the control group(t=3.002,2.413,6.666,9.656,P<0.05).The heart rate and mean arterial pressure had significant intergroup,time and interaction effects(Fgroup=12.366,10.525,Ftime=15.895,12.153,Finteraction=5.741,7.430,P<0.05).The total complication rate of the observation group was 9.26%,lower than 24.07%of the control group(χ2=4.267,P<0.05).The recov-ery time of spontaneous breathing in the observation group was(4.12±1.64)min,and the awakening time was(10.35±1.52)min,which was lower than that of the control group((5.43±1.76)min,(13.18±1.79)min)(t=4.002,8.856,both P<0.05).The visual analogue scale(VAS)scores of the observation group and the control group were respectively((1.24±0.21)points,(1.87±0.25)points)at 48 hours after the recovery,lower than((2.76±0.78)points,(2.03±0.42)points,(3.17±0.96)points,(2.57±0.63)points)at 12 and 24 hours after the recovery.The VAS scores were lower at 24 hours after the recovery than at 12 hours after the recovery.The VAS scores of the observation group were lower than those of the control group at different time points(t=2.436,5.241,14.179,P<0.05),and the VAS scores had effects between groups,time and interaction(Fgroups=18.520,Ftime=32.157,Finteraction=7.435,P<0.05).The levels of TNF-α and IL-6 of the observation group and the control group were respectively(8.61±1.25)ng·L-1,(10.74±1.42)ng·L-1,(6.84±1.15)pg·L-1 and(9.21±1.43)pg·L-1 at 48 hours after the surgery,higher than(3.46±0.8)ng·L-1,(3.59±0.91)ng·L-1,(2.64±0.38)pg·L-1 and(2.51±0.44)pg·L-1 before the surgery;the levels of the above indexes of the observation group were lower than those of the control group(t=8.274,9.491,P<0.05).Conclusion TAPB combined with butorphanol has better analgesic effect,which can stabilize the hemodynamics of patients undergoing laparoscopic cholecystectomy,improve the quality of postoperative awakening and reduce inflammatory response.