关键词: 达芬奇机器人手术, 多模式镇痛, 根治性膀胱切除

Abstract: ［Abstract］ Objective To explore the application value of multimodal analgesia in robot?assisted radical cystectomy and orthotopic ileal neobladder. Methods Sixty patients undergoing elective robot?assisted radical cystectomy and orthotopic ileal neobladder were divided into 2 groups（n=30）, multimodal analgesic group（group M）and control group（group C）. The analgesic strategy of group M were treated as follow：（1）Paracoxib sodium was used intravenously；（2）transverse abdominal plane block was performed；（3）no opioid patient controlled intravenous analgesia. The patients in group C were treated with conventional patient?controlled intravenous analgesia. The postoperative pain score, incidence of analgesia?related adverse reactions and postoperative rehabilitation of the two groups were collected and analyzed. Results The postoperative pain scores of 2 h, 6 h, 12 h, 24 h and 48 h in group M were significantly lower than those in C group. The incidence of nausea, vomiting, drowsiness, pruritus, hypotension, supplemental analgesics and additional antiemetic drugs in group M were lower than those in group Postoperative ambulation time, exhaust time, defecation time and hospitalization time in group M were significantly earlier than those in group C. Conclusion Multimodal analgesia can effectively alleviate postoperative pain of patients with radical cystectomy combined with orthotopic ileum and promote early bed removal by Da Vinci robot, which can help patients recover after operation and shorten the time of hospitalization.

Key words: Da Vinci robotic surgery, radical cystectomy, multimodal analgesia