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目的:探讨氢吗啡酮复合罗哌卡因腹横肌平面阻滞应用于腹腔镜子宫肌瘤手术的临床效果及对应激反应的影响。方法:选择浙江省绍兴市上虞中医医院2017年3月至2020年3月行腹腔镜子宫肌瘤手术患者100例，依据随机数字表法分为观察组和对照组，每组50例。两组均于麻醉诱导后实施腹横肌平面阻滞，对照组注射罗哌卡因，观察组注射氢吗啡酮复合罗哌卡因，比较两组入手术室即刻（Tn 0）、手术1 h（Tn 1）及术毕（Tn 2）血流动力学参数变化，术后3、12和24 h患者视觉模拟量表（VAS）评分，术中Ramsay镇静评分变化，及术前和术后24 h血清应激反应水平的变化。n 结果:两组术后不同时刻心率、收缩压和舒张压比较差异无统计学意义（n P > 0.05）。观察组术后3、12和24 h VAS评分低于对照组[（3.05 ± 0.32）分比（3.42 ± 0.39）分、（2.16 ± 0.38）分比（2.73 ± 0.43）分、（1.43 ± 0.29）分比（2.28 ± 0.35）分]，差异均有统计学意义（ n t = 5.186、7.024、13.223，n P<0.05）。观察组术中Ramsay镇静评分高于对照组[（3.79 ± 0.45）分比（2.54 ± 0.39）分]，差异有统计学意义（n t = 14.843，n P<0.05）。观察组术后24 h血清去甲肾上腺素、白细胞介素-6和皮质醇均低于对照组[（254.18 ± 14.35） pmol/L比（328.73 ± 18.69） pmol/L、（26.89 ± 4.10） ng/L比（35.27 ± 5.46） ng/L、（214.30 ± 21.28） pmol/L比（296.53 ± 32.19） pmol/L]，差异均有统计学意义（n t = 22.371、8.678、15.068，n P0.05). The VAS scores of the observation group at postoperative 3 h, 12 h and 24 h were lower than those in control group [(3.05 ± 0.32) scores vs. (3.42 ± 0.39) scores, (2.16 ± 0.38) scores vs. (2.73 ± 0.43) scores, (1.43 ± 0.29) scores vs. (2.28 ± 0.35) scores], and there were significant differences (n t = 5.186, 7.024, 13.223, n P<0.05). The scores of Ramsay sedation score in observation group was higher than that in control group [(3.79 ± 0.45) scores vs. (2.54 ± 0.39) scores], and there was significant difference (n t = 14.843, n P<0.05). The levels of noradrenaline, interleukin-6, and cortisol in observation group at postoperative 24 h were lower than those in control group [(254.18 ± 14.35) pmol/L vs. (328.73 ± 18.69) pmol/L, (26.89 ± 4.10) ng/L vs. (35.27 ± 5.46) ng/L, (214.30 ± 21.28) pmol/L vs. (296.53 ± 32.19) pmol/L], and there were significant differences (n t = 22.371, 8.678, 15.068, n P<0.05).n Conclusions:The combination of hydromorphone and ropivacaine in abdominal transverse plane block after laparoscopic myomectomy has good analgesic and sedative effects and can reduce stress response.