腰方肌阻滞联合无背景流量镇痛泵镇痛在腹腔镜老年结直肠癌手术患者的应用  

Application of analgesia with quadratus lumborum muscle block combined with analgesia pump without background flow in elderly patients undergoing laparoscopic colorectal cancer surgery

作　　者：吴传兵 李晓虎[1] 吴霭芬 何志青 吴晓燕 刘亨利 WU Chuanbing;LI Xiaohu;WU Aifeng(Department of Anesthesiology,Jiande First Peopled Hospital,Jiande 311600,CHINA)

机构地区：[1]建德市第一人民医院麻醉科,浙江311600

出　　处：《江苏医药》2021年第12期1226-1230,共5页Jiangsu Medical Journal

基　　金：建德市科技发展计划项目(2020YW05)。

摘　　要：目的观察腰方肌阻滞(QLB2)联合无背景流量镇痛泵在老年腹腔镜结直肠癌手术患者的镇痛效果。方法全身麻醉下行腹腔镜结直肠癌手术老年患者60例随机分为两组,每组30例。A组采用QLB2+无背景流量镇痛泵镇痛,B组采用常规背景流量镇痛泵镇痛。记录术后2 h(T1)、6 h(T2)、12 h(T3)、24 h(T4)和48 h(T5)的SpO_(2)、MAP、HR和RR,并行VAS疼痛评分和Ramsay镇静评分;记录术后初次排气时间及术后镇痛泵总按压次数。观察术后48 h内不良反应发生情况。结果两组T1〜T5的SpO_(2)、MAP、HR和RR变化无统计学差异(P>0.05),两组T1〜T5的VAS疼痛评分及Ramsay镇静评分亦无统计学差异(P>0.05)。A组术后首次排气时间早于B组[(46.50±4.54)h vs.(49.65±5.21)h](P<0.05),镇痛泵总按压次数少于B组[(3.43±0.65)次vs.(5.93±0.64)次](P<0.05)。A组不良反应发生率低于B组(P<0.05)。结论与常规背景流量镇痛泵术后镇痛比较,QLB2联合无背景流量镇痛泵行腹腔镜结直肠癌手术老年患者术后镇痛效果较好,镇痛用药量少,不良反应发生率低。Objective To observe the efficacy of analgesia with quadratus lumborum muscle block(QLB2)combined with analgesia pump without background flow in elderly patients undergoing laparoscopic colorectal cancer surgery.Methods Sixty elderly patients undergoing laparoscopic colorectal cancer surgery under general anesthesia were randomly divided into two groups,with 30 cases each.Analgesia was performed with QLB2+analgesia pump without background flow(group A)or with conventional analgesia pump(group B).At the time points of postoperative 2 hours(T1),6 hours(T2),12 hours(T3),24 hours(T4)and 48r hours(T5),SpO_(2),MAP,HR and RR were recorded,VAS pain score and Ramsay sedation score were evaluated.The first exhaust time and the total times of postoperative analgesic pump pressing were recorded.The incidence of adverse responses within 48 hours after operation was observed.Results There were no significant differences at T1-T5 between the two groups in the changes of SpO_(2),MAP,HR,RR,VAS pain score and Ramsay sedation score(P>0.05).The first exhaust time in group A was earlier than that in group B[(46.50±4.54)hours vs.(49.65±5.21)hours](P<0.05).The total times of postoperative analgesic pump pressing in group A was less than that in group B[(3.43±0.65)times vs.(5.93±0.64)times](P<0.05).The incidence of adverse responses was lower in group A than that in group B(P<0.05).Conclusion Compared to analgesia with conventional analgesia pump for the elderly patients undergoing laparoscopic colorectal cancer surgery,analgesia with QLB2+analgesia pump without background flow has better postoperative analgesia efficacy with reduced use of analgesic medication and lower incidence of adverse responses.

关 键 词：腰方肌阻滞 结直肠癌 术后镇痛 

分 类 号：R614[医药卫生—麻醉学]