关键词: 原发性肝癌, 腹腔镜下肝癌切除术, 腹横肌平面阻滞, 罗哌卡因, 镇痛

Abstract: Objective The aim of this study was to investigate postoperative analgesia by transversus abdominis plane block(TAPB) with ropivacainein patients with primary liver cancer (PLC) undergoing laparoscopic hepatectomy. Methods 49 patients with PLC were encountered in our hospital between April 2021 and June 2023, and all underwent laparoscopic hepatectomy. The patients were assigned to receive TAPB with ropivacaine (n=26) or normal saline (n=23) for post-operational analgesia. Visual analogue scales (VAS)was conducted, and peripheral blood lymphocyte subsets were determined by FCM. Serummalondialdehyde(MDA), superoxide dismutase(SOD)and total-antioxidant capability(T-AOC)were assayed. Results by 24 hours and 48 hours after operation, rest VAS score in TAPB group were (2.1±0.5)points and (2.0±0.6)points, both significantly lower than [(2.8±0.7)points and (2.7±0.6)points, P＜0.05], and motion VAS score were (3.5±0.8)points and (2.8±0.6)points, also much lower than [(4.1±1.0)points and (3.7±1.0)points, P＜0.05] in control group; before and after operation, there were no significant differences as respect to peripheral blood lymphocyte subset percentages between the two groups (P＞0.05); by 24 hours, serum MDA level in the TAPB group was (3.6±0.8)mmol/L, significantly lower than [(4.9±1.6)mmol/L, P<0.05], while serum SOD and T-AOC levels were (81.0±10.3)U/mL and (21.4±3.9)U/mL, both much higher than [(72.2±11.3)U/mL and (15.6±4.3)U/mL, P<0.05] in the control; there was no significant difference in adverse events between the two groups (7.7% vs. 17.4%,P=0.400). Conclusion The TAPB with ropivacaine in PLC patients after laparoscopic hepatectomy could alleviate postoperative pain, which might inhibit body inflammatory reaction and protect antioxidant capacity.

Key words: Hepatoma, Laparoscopic hepatectomy, Transversus abdominis plane block, Ropivacaine, Analgesia