Đánh giá kết quả của phương pháp giảm đau sau mổ đa mô thức trong chăm sóc bệnh nhân phẫu thuật cắt gan

Abstract

Objective: To assess the short-term outcome of multimodal analgesia in post-hepatectomy care for hepatocellular carcinoma patients. Subject and method: Our descriptive study included 53 patients undergoing hepatectomy at Department of Hepatopancreato-biliary Surgery, 108 Military Central Hospital from 03/2023 to 7/2023, with no contraindication for analgesic methods. All patients were administered one the three following analgesic method: (1) patient-controlled epidural analgesia (PCEA); (2) intravenous patient-controlled analgesia; (3) tissue numbness. All patients were combined with intravenous paracetamol 1g combined nefopam 20mg every 6 hours (on the first 3 post-operative days), and oral ultracet (325/37.5mg) on the following days. The patients were then assessed on pain relief efficacy and adverse events. Result: The mean age was 55.25 ± 14.7 years old. Male contributed 92.5% patients. The mean operative time was 152.2 ± 56 minutes. 100% patients had stable vital signs. Patients endured mild to moderate pain, both when static and mobile, then decreased on postoperative day 3. From the 16^th hour, 34% patients could walk along our department corridors. This ratio gradually increased and reached 100% on day 5. Rate of high satisfaction was 73.7%, of moderate satisfaction was 26.4%. Conclusion: Multimodal analgesia in post-hepatectomy care for hepatocellular carcinoma showed good efficacy and corresponded with ERAS criteria.