关键词: 腹腔镜检查, 子宫切除术, 镇痛

Abstract: Objective To explore the comparison of the effects of percutaneous electrical stimulation for preemptive analgesia and intravenous infusion of lidocaine combined with dexmedetomidine before anesthesia induction in laparoscopic hysterectomy. 
Methods A total of 140 patients who underwent laparoscopic hysterectomy in Northwest Women and Children′s Hospital were selected, and the patients were divided into Group A (n=70) and Group B (n=70) by a random number table method. Both groups underwent laparoscopic hysterectomy, Group A received percutaneous electrical stimulation for preemptive analgesia, while Group B received intravenous infusion of lidocaine combined with dexmedetomidine before anesthesia induction. The differences including duration of operation, intraoperative blood loss, and adverse reactions between the two groups were observed. In the meantime, the differences in heart rate (HR), mean arterial pressure (MAP), oxygen saturation (SpO2), bispectral index (BIS), stress inflammatory factors, and visual analogue scale (VAS) pain score between the two groups at different time points were observed. 
Results The awakening time and extubation time of Group A were significantly faster than those of Group B (P＜0.04). HR, MAP, and BIS values of Group A and Group B showed a decrease followed by an increase, with significant differences in time points (P＜0.05). However, there was no significant difference in the interaction between groups or time points between groups (P＞0.05). There was no significant difference in postoperative cortisol (Cor), norepinephrine (NE), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and C-reactive protein (CRP) between the two groups (P＞0.05). There was no significant difference in VAS pain scores between the two groups at 2, 6, 12, and 24 h after surgery (P＞0.05). The incidence rates of malignant vomiting, postoperative cognitive impairment, and bradycardia in Group A were significantly lower than those in Group B (P＜0.05). 
Conclusion Percutaneous electrical stimulation for preemptive analgesia and intravenous infusion of lidocaine combined with dexmedetomidine before anesthesia induction has good application value in laparoscopic hysterectomy. Among them, percutaneous electrical stimulation for preemptive analgesia has faster postoperative recovery and lower incidence of adverse reactions. 

Key words: hysterectomy, laparoscopy, analgesia