全身麻醉联合区域神经阻滞对腹腔镜结直肠癌根治术患者应激指标和疼痛及术后恢复的影响  

The effect of general anesthesia combined with regional nerve block on stress indicators,pain,and postoperative recovery in patients undergoing laparoscopic radical resection of colorectal cancer

作　　者：王有[1] WANG You(Department of Obstetrics and Gynecology,Dalian Hospital,Shengjing Hospital of China Medical University,Dalian,Liaoning,116600,China)

机构地区：[1]中国医科大学附属盛京医院大连医院妇产科,辽宁大连116600

出　　处：《当代医学》2023年第32期170-173,共4页Contemporary Medicine

摘　　要：目的探讨全身麻醉联合区域神经阻滞在腹腔镜结直肠癌根治术患者中的应用价值。方法选取2019年3月至2021年3月中国医科大学附属盛京医院大连医院收治的82例腹腔镜结直肠癌根治术患者作为研究对象,按照随机数字表法分为对照组与研究组,每组41例。对照组采用全身麻醉,研究组采用全身麻醉+区域神经阻滞。比较两组应激反应[皮质醇(Cor)、脉搏血氧饱和度(SpO2)、平均动脉压(MAP)、去甲肾上腺素(NE)]、术后疼痛程度[视觉模拟评分法(VAS)]、术后恢复情况及不良反应发生情况。结果术毕,研究组Cor、SpO2、MAP、NE水平与麻醉前比较差异无统计学意义;对照组Cor、SpO2、MAP、NE水平均高于麻醉前和研究组,差异有统计学意义(P<0.05)。拔管后30 min及术后6、12、24 h,研究组VAS评分均低于对照组,差异有统计学意义(P<0.05)。研究组术后呼吸恢复、苏醒、肛门排气、拔出气管导管、卧床时间均短于对照组,不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论全身麻醉联合区域神经阻滞能减轻腹腔镜结直肠癌根治术患者围手术期应激反应,可明显改善术后镇痛效果,有利于患者术后恢复,且安全可靠,值得临床推广应用。Objective To explore the application value of general anesthesia combined with regional nerve block in patients undergoing laparoscopic radical resection of colorectal cancer.Methods 82 patients with laparoscopic radical resection of colorectal cancer admitted to Dalian Hospital,Shengjing Hospital of China Medical University from March 2019 to March 2021 were selected as the study subjects.They were randomly divided into the control group and the study group according to random number table method,with 41 cases in each group.The control group received general anesthesia,while the study group received general anesthesia combined with regional nerve block.The stress responses(cortisol[Cor],saturation of peripheral oxygen[SpO2],mean arterial pressure[MAP],norepinephrine[NE]),postoperative pain severity(visual analog scale[VAS]),postoperative recovery,and incidence of adverse reactions were compared between the two groups.Results At the end of operation,the levels of Cor,SpO2,MAP and NE in the study group were not significantly different from those before anesthesia.The levels of Cor,SpO2,MAP and NE in the control group were higher than those before anesthesia and in the study group,the differences were statistically significant(P<0.05).At 30 min after extubation and 6,12,24 h after operation,the VAS scores in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).The time of postoperative respiratory recovery,recovery,anal exhaust,extubation and bed rest in the study group were shorter than those in the control group,and the incidence of adverse reactions was lower than that in the control group,the differences were statistically significant(P<0.05).Conclusion General anesthesia combined with regional nerve block can alleviate perioperative stress response in patients undergoing laparoscopic radical resection of colorectal cancer,significantly improve postoperative pain relief,facilitate postoperative recovery,and is safe and reliable,which is worthy of

关 键 词：腹腔镜 结直肠癌根治术 全身麻醉 区域神经阻滞 应激反应 术后恢复 

分 类 号：R735.3[医药卫生—肿瘤]