Journal of Shandong University (Health Sciences) ›› 2019, Vol. 57 ›› Issue (9): 43-47.doi: 10.6040/j.issn.1671-7554.0.2018.784

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Effects of multimodal analgesia on the intestinal function of 45 patients who received robotic distal gastrectomy

ZHAO Jian1,2*, HAN Xiaoling2*,WANG Gang2, LIU Jiang2, ZHOU Jiahui3, WANG Haifeng1,2, JIANG Zhiwei2, LI Jieshou1   

  1. 1. Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing 210002, Jiangsu, China;
    2. Department of General Surgery, Jiangsu Province Hospital of Chinese Medicine, Nanjing 210029, Jiangsu, China;
    3. Research Institute of General Surgery, Jinling Clinical Medical College, Nanjing Medical University, Nanjing 210002, Jiangsu, China
  • Published:2022-09-27

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Abstract: Objective To explore the effects of multimodal analgesia on the intestinal function after robotic distal gastrectomy under an enhanced recovery after surgery(ERAS)pathway. Methods During Nov. 2017 and June 2018, 45 patients who received robotic distal gastrectomy were divided into the multimodal analgesia(MMA)group and patient-controlled intravenous analgesia(PCIA)group. Analgesic methods in the MMA group consisted of incision infiltration 山 东 大 学 学 报 (医 学 版)57卷9期 -赵健,等.多模式止痛对机器人45例远端胃切除术后肠功能的影响 \=-with ropivacaine before closure, intravenous injection of parecoxib after the operation, intravenous injection of methylprednisolone after the surgery, and oral administration of oxycodone/acetaminophen tablets. Patients in PCIA group were given PCIA pump with tramadol. Postoperative intestinal function and analgesic effects were observed. Results In the MMA and PCIA groups, the time to first flatus was ［2(2,3)d vs 3(2,3.5)d, Z=-2.302, P=0.021］, time to recover semi-liquid diet was ［2(2,3)d vs 3.5(3,4)d, Z=-3.032, P=0.002］, time to first off-bed activity was ［1(1,1)d vs 2(1.5,2)d, Z=-5.217, P<0.001］, and postoperative length of stay was ［4(4,5)d vs 5(4,7)d, Z=-2.501, P=0.012］. Complication rates in two groups were similar. From day 1 to the day 3 after surgery, VAS scores were similar in the two groups on coughing and at rest. Conclusion Under an ERAS pathway, multimodal analgesia accelerates intestinal function recovery after robotic distal gastrectomy, and its analgesic effects are similar to PCIA.

Key words: Multimodal analgesia, Robotic surgery, Enhanced recovery after surgery, Intestinal function

CLC Number: 

  • R619
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