Objective:To explore the clinical effect of different concentrations of ropivacaine in phrenic nerve block.Methods:A total of 180 patients who underwent laparoscopic total hysterectomy at Yichang Central People's Hospital from January 2022 to May 2023 were selected and divided into six groups using a random number table method:group A(0.125％ropivacaine,n=30),group B(0.25％ropivacaine,n=30),group C(0.375％ropivacaine,n=30),group D(0.5％ropivacaine,n=30),group E(0.75％ropivacaine,n=30),and the control group(no phrenic nerve block,n=30).Among them,patients in groups A to E underwent ultrasound-guided right phrenic nerve block before surgery.The visual analog scale(VAS)score for shoulder pain,diaphragmatic movement amplitude(DM),postoperative recovery,and adverse reactions were evaluated in each group.Results:In terms of postoperative shoulder pain,the VAS scores in groups C(2.47±1.14 vs 4.03±1.77),D(2.53±1.22 vs 4.03±1.77),and E(2.50±1.22 vs 4.03±1.77)were significantly lower than those in the control group(all P＜0.05).In terms of DM,the patients in groups D and E after 10 min of phrenic nerve block was significantly lower than that in the control group(both P＜0.05).In terms of anesthesia recovery time,the PACU stay time of patients in groups D[(22.50±2.16)min vs(20.73±1.76)min]and E[(22.80±2.63)min vs(20.73±1.76)min]was significantly longer than that in the control group(both P＜0.05).In terms of postoperative recovery quality,the 15-item quality of recovery(QoR-15)scores at 24 h after surgery in groups C,D,and E were significantly higher than those in the control group(all P＜0.05).The incidence of total adverse reactions in group E was significantly higher than that in the control group(43.33％vs 16.67％).Conclusion:The use of 0.375％ropivacaine for right phrenic nerve block is safe and effective,which can effectively reduce postoperative shoulder pain and improve postoperative recovery quality in patients undergoing laparoscopic total hysterectomy,without affecting diaphragmatic function recovery and PACU stay time.It is worthy of clinical promotion and application.
ropivacainephrenic nerve blockdiaphragmatic movement amplitudeshoulder pain
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