摘要
目的:探索超声引导下腰方肌阻滞在子宫肌瘤患者机器人辅助手术中的镇痛效果、应激水平及苏醒质量的影响。方法:前瞻性选取2020年5月—2023年5月在太和医院行机器人辅助子宫肌瘤剔除术的80例患者,采用随机数字表法分为两组,对照组40例进行全凭静脉麻醉,观察组40例实施超声引导下腰方肌阻滞后再行全麻,比较两组麻醉效果。结果:观察组拔除气管导管时间、呼之睁眼时间、恢复室停留时间、术后下床活动时间、定向力恢复时间短于对照组,丙泊酚用量、术后24 h镇痛泵按压次数少于对照组,术后躁动率低于对照组。同时观察组术后VAS评分低于对照组,术中及术后的血氧饱和度、平均动脉压、心率均高于对照组,NE、COR、GLU均低于对照组。结论:对行机器人辅助手术子宫肌瘤剔除术患者进行超声引导下腰方肌阻滞麻醉,具有较好镇痛、镇静效果,可缩短定向力恢复时间,稳定围手术期血流动力学,减轻机体应激状况。
Objective:To explore the analgesic effect of ultrasound-guided quadratus lumborum block in robotassisted surgery for patients with uterine fibroids and its effect on stress level and quality of awakening.Methods:80 patients with uterine fibroids who underwent robot-assisted uterine myomectomy at Taihe hospital from May 2020 to May 2023 were prospectively selected.They were randomly divided into the control group and the observation group using random number table method.The control group(n=40)received total intravenous anesthesia(TIVA),while the observation group(n=40)received ultrasound-guided quadratus lumborum block before general anesthesia.The anesthesia effects of the two groups were compared.Results:Compared to the control group,the observation group had shorter time for removing the endotracheal tube,eye opening to speech,recovery room staying time,postoperative mobilization time,and directional force recovery time.The dosage of propofol and the number of analgesic pump press at 24 hours after surgery were lower than those in the control group.The rate of postoperative agitation was lower in the observation group than that in the control group.Meanwhile,the observation group had a lower postoperative VAS scores compared to the control group.Intraoperative and postoperative SpO2,MAP,and HR were higher in the observation group than those in the control group,and the NE,COR,and GLU levels were lower in the observation group than those in the control group.Conclusion:Ultrasound-guided quadratus lumborum block is more effective for patients with uterine fibroids undergoing robot-assisted surgery,which could provide patients with better analgesia and sedation,shorten recovery time,stabilize perioperative hemodynamics,and reduce stress on the body.
作者
宋晓雨
陈炫龙
孙艳芳
SONG Xiaoyu;CHEN Xuanlong;SUN Yanfang(Department of Ultrasound Medicine,Taihe Hospital of Shiyan city,Affiliated Hospital of Hubei University of Medicine,Shiyan 442000,China;Department of Ultrasound Medicine,Wuhan Third Hospital,Wuhan 430060,China)
基金
湖北省卫生健康委员会科研项目(WJ2020M255)。
关键词
超声引导
腰方肌阻滞
子宫肌瘤
机器人辅助手术
镇痛
应激水平
苏醒质量
Ultrasound-guided
Quadratus Lumborum Block
Uterine Fibroid
Robot-assisted Surgery
Analgesia
Stress Level
Awakening Quality
