摘要
目的探索超声引导下外侧弓上韧带腰方肌阻滞用于开腹肝切除术后镇痛的效果。方法前瞻性选取2022年4月至2023年5月我院106例行开腹肝切除术的患者,采用随机数字表法分对照组(采用超声引导下肋下腹横肌平面阻滞)和观察组(采用超声引导下外侧弓上韧带腰方肌阻滞),每组53例。比较2组患者术后恢复指标、免疫功能以及各时间点数字评分量表(NRS)评分和Ramsay镇静评分,统计住院期间不良反应发生率。结果观察组患者下床活动时间、肛门排气时间早于对照组(P<0.05),48 h内舒芬太尼用量、镇痛泵按压次数少于对照组(P<0.05),术后6 h、12 h的Ramsay镇静评分高于对照组(P<0.05),术后6 h、12 h、24 h、48 h静息时和咳嗽时的NRS评分均低于对照组(P<0.05),术后24 h的CD_(4)^(+)、NK、CD_(4)^(+)/CD_(8)^(+)高于对照组(P<0.05)。2组患者术后不良反应发生率比较差异无统计学意义(P>0.05)。结论开腹肝切除术患者行超声引导下外侧弓上韧带腰方肌阻滞麻醉,能够获得理想的镇痛、镇静效果,促进患者术后恢复。
Objective To explore the analgesic effect of ultrasound-guided quadratus lumborum block at lateral supra-arcuate ligament after open hepatectomy.Methods A total of 106 patients with open hepatectomy in our hospital from April 2022 to May 2023 were selected prospectively and randomly divided into the control group(anesthetized by ultrasound-guided subcostal transverse abdominis plane block)and the observation group(anesthetized by ultrasound-guided quadratus lumborum block at lateral supra-arcuate ligament),with 53 cases in each group.The postoperative recovery index,immune function,and numerical rating scale(NRS)score and Ramsay sedation score in each time point of patients in the two groups were compared,and the incidence of adverse reactions during hospitalization was counted.Results The time of getting out of bed and anal discharge time of patients in the observation group were earlier than those in the control group(P<0.05),the dosage of sufentanil in 48 hours and numbers of analgesic pump compressions were less than those in the control group(P<0.05),Ramsay sedation scores 6 hours and 12 hours after surgery were higher than those in the control group(P<0.05),NRS scores at resting and cough 6 hours,12 hours,24 hours after surgery were lower than those in the control groups(P<0.05),the contents of CD_(4)^(+),NK and CD_(4)^(+)/CD_(8)^(+)24 hours after surgery were higher than those in the control group(P<0.05).There was no statistically significant difference in the incidence of postoperative adverse reactions between the two groups(P>0.05).Conclusion Ultrasound-guided quadratus lumborum block at lateral supra-arcuate ligament in patients with open hepatectomy can achieve ideal analgesic and sedative effects,and promote postoperative recovery.
作者
张雷
丁亚军
康培培
ZHANG Lei;DING Ya-jun;KANG Pei-pei(Department of Anesthesiology,Cancer Hospital Affiliated to Nantong University,Nantong Jiangsu 226361,China)
出处
《局解手术学杂志》
2024年第11期955-958,共4页
Journal of Regional Anatomy and Operative Surgery
基金
2022年度南通市基础科学研究和社会民生科技计划项目(MSZ2022018)。
关键词
超声
外侧弓上韧带腰方肌阻滞
肋下腹横肌平面阻滞
开腹肝切除术
镇痛
ultrasound
quadratus lumborum block at lateral supra-arcuate ligament
subcostal transverse abdominis plane block
open hepatectomy
analgesia
