关键词: 胆囊结石, 单孔腹腔镜胆囊切除术, 腹横肌平面阻滞, 布比卡因脂质体, 镇痛

Abstract: Objective The purpose of this study was to compare the analgesic efficacy of liposomal bupivacaine (LB) and ropivacaine (R) for transversus abdominis plane block (TAPB) after single-hole laparoscopic cholecystectomy (SHLC) in patients with gall bladder stones. Methods 79 patients with cholecystolithiasis were encountered in our hospital between March 2024 and March 2025, and all patients underwent SHLC. They were randomly divided into two groups when transferred into post-anesthesia care unit (PACU), for TAPB by LB (n=39) or by R(n=40) under ultrasound guidance. The numerical rating scale (NRS)for pain and Athens insomnia scale (AIS) were recorded. Results There were no statistically significant differences as respect to surgery time, anesthesia time and remifentanil doses used in the two groups (P>0.05); 12 h, 24 h, 48 h and 72 h post-operationally, the NRS scores at exercise in LB group were(3.1±1.1), (2.8±1.1), (2.6±0.9) and (2.1±0.8), all significantly lower than [(4.2±1.1), (4.4±1.2),(3.8±1.1) and (2.9±0.9), P＜0.05], and NRS scores at resting were (2.3±1.0), (2.1±0.9), (1.9±1.0) and (1.4±0.8), all significantly lower than [(3.6±1.0), (3.3±1.0), (2.7±0.9) and (2.1±1.0), respectively, P＜0.05] in R group; the AIS score at post of day one in LB group was(7.6±1.3), much lower than [(8.5±1.1), P＜0.05] in R group; post-operationally, first flatus and ambulation times in LB group were (26.1±4.4)h and (16.6±4.2)h, both significantly shorter than [(29.5±4.8)h and (22.4±4.2)h, respectively, P＜0.05], and incidence of rescue analgesia was 10.3%, much lower than 32.5%(P＜0.05) in R group. Conclusion Liposomal bupivacaine under ultrasound-guided TAPB could be safely and effectively conducted for postoperative analgesia in patients with cholecystolithiasis undergoing SHLC, which might provide ascertained analgesic efficacy.

Key words: Cholecystolithiasis, Liposomal bupivacaine, Transversus abdominis plane block, Single-hole laparoscopic cholecystectomy, Analgesia