摘要
目的探究右美托咪定辅助超声引导下腹横筋膜阻滞用于结直肠癌根治术的效果及对患者认知功能及血清儿茶酚胺水平的影响。方法抽取2020年3月至2023年3月河南大学第一附属医院收治的结直肠癌根治术患者68例,根据随机数字表法分为对照组(32例)和观察组(36例),两组患者均采用全身麻醉诱导后超声引导下行双侧腹横筋膜阻滞,对照组给予0.5%罗哌卡因40 ml,观察组在对照组基础上加用右美托咪定1μg/kg。观察两组手术情况,比较两组术前及术后3 d的神经认知功能[简易智能量表(MMSE)评分]和血清儿茶酚胺水平[去甲肾上腺素(NE)、肾上腺素(EPI)、多巴胺(DA)],比较两组术后谵妄发生情况。结果两组手术时长和麻醉时长比较差异未见统计学意义(P>0.05);观察组瑞芬太尼和丙泊酚用量少于对照组(P<0.05)。术后3 d,两组MMSE评分均较术前改善,且观察组MMSE评分高于对照组(P<0.05);术后3 d,两组NE、EPI、DA水平均高于术前,但观察组上述指标低于对照组(P<0.05)。观察组术后谵妄总发生率(2.78%,1/36)低于对照组(18.75%,6/32),P<0.05。结论右美托咪定辅助腹横筋膜阻滞用于结直肠癌根治术患者可减少术中瑞芬太尼和丙泊酚用量,保护神经认知功能,有效调节血清儿茶酚胺水平。
Objective To investigate the application of dexmedetomidine assisted ultrasound-guided transversalis fascia plane block in colorectal cancer radical surgery and its influence on cognitive function and serum catecholamine level.Methods A total of 68 patients who underwent radical resection of colorectal cancer in the First Affiliated Hospital of Henan University from March 2020 to March 2023 were selected,and they were divided into control group(32 cases)and observation group(36 cases)according to the random number table method.Both groups underwent bilateral transversalis fascia plane block guided by ultrasound after general anesthesia induction.The control group received 0.5%ropivacaine 40 ml,and the observation group received 1μg/kg dexmedetomidine based on the anesthesia protocol of the control group.The surgical conditions of two groups were observed.The neurocognitive function assessed by mini-mental state examination(MMSE)score and levels of serum catecholamines,including norepinephrine(NE),epinephrine(EPI)and dopamine(DA),were compared between the two groups before and 3 days after surgery.The incidence of postoperative delirium were compared between the two groups.Results There was no significant difference in the operation time and anesthesia duration between the two groups(P>0.05).The dosage of remifentanil and propofol in the observation group were less than those in the control group(P<0.05).Three days after operation,the MMSE score of both groups were superior to those before operation,and the MMSE score of the observation group was higher than that of the control group(P<0.05).Three days after operation,the levels of NE,EPI and DA in both groups were higher than those before surgery,but the above indicators in the observation group were lower than those in the control group(P<0.05).The total incidence of postoperative delirium in the observation group(2.78%,1/36)was lower than that in the control group(18.75%,6/32),P<0.05.Conclusions The use of dexmedetomidine assisted ultrasound-guided transversal
作者
宋直雷
宋俊杰
毛珊珊
陈虹秀
Song Zhilei;Song Junjie;Mao Shanshan;Chen Hongxiu(Department of Anesthesiology and Perioperative Medicine,the First Affiliated Hospital of Henan University,Kaifeng 475000,China)
出处
《中国实用医刊》
2023年第19期28-31,共4页
Chinese Journal of Practical Medicine
基金
河南省医学科技攻关计划项目(LHGJ20220658)。
关键词
结直肠癌
右美托咪定
腹横筋膜阻滞
认知功能
儿茶酚胺
Colorectal neoplasms
Dexmedetomidine
Transversalis fascia plane block
Cognitive function
Catecholamine
