喉罩全身麻醉联合“圈麻”阻滞用于结肠癌手术的麻醉效果  

Efficacy of laryngeal mask general anesthesia combined with “loop anesthesia” block for colon cancer surgery

作　　者：傅志海[1] 陈再治[1] 马丽君 曲轶涛 林梅媛 陈林辉 FU Zhihai;CHEN Zaizhi;MA Lijun;QU Yitao;LIN Meiyuan;CHEN Linhui(Department of Anesthesiology,the Third Hospital of Xiamen,Xiamen 361100,Fujian,China)

机构地区：[1]厦门市第三医院麻醉科,福建厦门361100

出　　处：《中国现代医生》2024年第16期38-41,共4页China Modern Doctor

基　　金：福建省厦门市医疗卫生指导性项目(3502Z20224DZ1337)。

摘　　要：目的 观察喉罩全身麻醉联合腹部“圈麻”阻滞用于腹腔镜下结肠癌切除手术的麻醉效果。方法 选取2022年1月至2023年3月于厦门市第三医院行腹腔镜下结肠癌切除手术的患者60例,根据随机数字表法将其分为L组(喉罩全身麻醉,30例)和U组(喉罩全身麻醉联合腹部“圈麻”阻滞,30例)。记录并比较两组患者麻醉维持的丙泊酚和瑞芬太尼用量、手术完成时间、意识清醒后视觉模拟评分法(visual analogue scale,VAS)评分和舒芬太尼用量。比较两组患者术后12h的镇痛满意度。结果 两组患者的性别、年龄、体质量、身高、手术时间比较差异均无统计学意义(P>0.05)。U组患者的瑞芬太尼和丙泊酚总用量均显著少于L组(P<0.001);U组患者麻醉恢复室内的VAS评分显著低于L组,舒芬太尼用量显著少于L组(P<0.001)。U组患者的镇痛满意度显著高于L组(χ^(2)=6.772,P=0.031)。结论 与单一喉罩全身麻醉相比,喉罩全身麻醉联合腹部“圈麻”阻滞可减少腹腔镜下结肠癌切除手术中麻醉维持药物和麻醉恢复室内舒芬太尼的用量,改善术后镇痛满意度。Objective To observe the anesthetic effect of laryngeal mask general anesthesia combined with abdominal “loop anesthesia” block in laparoscopic resection of colon cancer.Methods A total of 60 patients who underwent laparoscopic resection of colon cancer in the Third Hospital of Xiamen from January 2022 to March 2023 were selected.According to random number table method,they were divided into L group(laryngeal mask general anesthesia,30 cases) and U group(laryngeal mask general anesthesia combined with abdominal “loop anesthesia” block,30 cases).The dosage of propofol and remifentanil for anesthesia maintenance,time to completion of surgery,visual analogue scale(VAS) score after consciousness and sufentanil dosage were recorded and compared between two groups.The satisfaction of analgesia 12h after surgery was compared between two groups.Results There were no significant differences in gender,age,body mass,height and operation time between two groups(P>0.05).The total dosage of remifentanil and propofol in U group was significantly lower than that in L group(P<0.001).The VAS score in the anesthesia recovery room of U group was significantly lower than that of L group,and the dosage of sufentanil was significantly lower than that of L group(P<0.001).The satisfaction of analgesia in U group was significantly higher than that in L group(χ^(2)=6.772,P=0.031).Conclusion Compared with laryngeal mask general anesthesia,laryngeal mask general anesthesia combined with abdominal “loop anesthesia” block can reduce the amount of anesthesia maintenance drugs in laparoscopic colon cancer resection,reduce the amount of sufentanil in the anesthesia recovery room,and improve the satisfaction of postoperative analgesia.

关 键 词：喉罩 腹直肌鞘阻滞 腰方肌阻滞 腹横肌平面阻滞 腹腔镜下结肠癌切除术 

分 类 号：R614[医药卫生—麻醉学]