摘要
目的探讨超声引导下腰方肌阻滞(QLB)联合丙泊酚麻醉在经腹结直肠癌(CRC)根治术患者中的应用价值。方法选择本院收治的经腹CRC根治术患者82例,依据随机数字表法分为2组,每组41例。对照组实施传统腰麻联合丙泊酚麻醉,研究组实施超声引导下QLB联合丙泊酚麻醉。对比2组应激反应、血流动力学、镇痛效果、术后恢复情况及不良反应。结果麻醉后1 h,研究组皮质醇(Cor)[(471.91±27.34)nmol/L]、肾上腺素(E)[(53.61±5.92)pg/mL]分别低于对照组[(490.59±28.02)nmol/L、(59.76±6.13)pg/mL],差异有统计学意义(t=3.055、4.621,P=0.003、<0.001);切片后5 min(T2)、切片后2 h(T3)、手术结束时(T4),研究组心率(HR)、平均动脉压(MAP)均高于对照组(差值分别为5.2次/min、5.74次/min、5.37次/min和6.58 mmHg、6.67 mmHg、5.67 mmHg),差异均有统计学意义(P<0.001);研究组术后不同时间点视觉模拟评分法(VAS)低于对照组(差值分别为0.44分、0.48分、0.56分、0.41分),差异均有统计学意义(P<0.001);苏醒时间、首次肛门排气时间、首次下床活动时间及住院时间分别短于对照组(差值分别为5.03 min、7.58 h、6.71 h、1.09 d),差异均有统计学意义(P<0.001);不良反应发生率(4.88%)低于对照组(19.51%),差异有统计学意义(χ^(2)=4.100,P=0.043)。结论超声引导下QLB联合丙泊酚麻醉可起到良好镇痛之效,能够减轻经腹CRC根治术患者机体应激,维持术中血流动力学稳定,利于术后恢复,且麻醉安全性高,值得临床推广应用。
Objective To explore the application value of ultrasound-guided quadratus lumbosacral block(QLB)combined with propofol anesthesia in patients undergoing abdominal radical resection of colorectal cancer(CRC).Methods Eighty-two patients with abdominal CRC radical operation in our hospital were selected and divided into two groups according to the random number table method,with 41 cases in each group.The control group was given traditional spinal anesthesia combined with propofol anesthesia,while the study group was given QLB combined with propofol anesthesia under ultrasound guidance.The stress response,hemodynamics,analgesic effect,postoperative recovery,and adverse reactions were compared between the two groups.Results One hour after anesthesia,the cortisol(Cor)and epinephrine(E)in the study group were lower than those in the control group:,respectively and the differences were statistically significant(t=3.055,4.621,P=0.003,<0.001).The heart rate(HR)and mean arterial pressure(MAP)in the study group were higher than those in the control group at 5 minutes(T2),2 hours(T3),and end of the operation(T4)(the differences were 5.2 beats/min,5.74 beats/min,5.37 beats/min and 6.58mmHg,6.67mmHg,and 5.67mmHg),respectively.The visual analogue scale(VAS)in the study group was lower than that in the control group at different time points after the operation(the differences were 0.44,0.48,0.56,and 0.41 respectively),and the differences were statistically significant(P<0.001).The recovery time,the first anal exhaust time,the first time to get out of bed,and the hospitalization time in the study group were shorter than those in the control group(the differences were 5.03 min,7.58 h,6.71 h,and 1.09 d),respectively and the differences were statistically significant(P<0.001).The incidence of adverse reactions was 4.88%in the study group,which was lower than that in the control group:19.51%and the difference was statistically significant(χ^(2)=4.100,P=0.043).Conclusions Ultrasound-guided QLB combined with propofol anesthesia has a
作者
赵勇辉
彭辉
张国庆
ZHAO Yonghui;PENG Hui;ZHANG Guoqing(Department of Anesthesiology,Zhumadian Central Hospital,Zhumadian 463000,Henan,China)
出处
《中国校医》
2023年第6期463-465,479,共4页
Chinese Journal of School Doctor
关键词
经腹结直肠癌根治术
超声引导
腰方肌阻滞
丙泊酚
血流动力学
镇痛效果
Abdominal radical operation for colorectal cancer
Ultrasound guidance
Quadratus lumbosacral block(QLB)
Propofol
Hemodynamics
Analgesic effect
