SAPB与QLB联合全麻用于腹腔镜肾癌根治术后镇痛的效果研究  

Comparison of anesthetic efficacy and subserratus anterior plane block and quadratus lumborum block combined with general anesthesia for laparoscopic radical nephrectomy

作　　者：辛佳映 白雪波[1] 李兆国 Xin Jiaying;Bai Xuebo;Li Zhaoguo(Department of Anesthesiology,Affiliated Hospital of Jining Medical University,Jining 272000,China)

机构地区：[1]济宁医学院附属医院麻醉科,济宁272000

出　　处：《国际泌尿系统杂志》2024年第5期859-863,共5页International Journal of Urology and Nephrology

摘　　要：目的比较低位前锯肌平面阻滞(SAPB)与腰方肌阻滞(QLB)联合全身麻醉在腹腔镜下肾癌根治术中的麻醉效果和安全性。方法回顾性分析2023年1月至2023年10月本院收治的140例肾癌患者的临床资料,依据不同麻醉方法将患者分为低位前锯肌组(行SAPB联合全身麻醉)和腰方肌阻滞组(行QLB联合全身麻醉),每组各70例。分析两组患者的阻滞操作时间、阻滞起效时间、麻醉药用量、视觉模拟评分(VAS)、恢复质量评分-15项(QOR-15)和不良反应发生率。结果SAPB操作时间和阻滞起效时间均短于腰方肌阻滞组(均P<0.05)。术后2 d,低位前锯肌组患者的QOR-15评分高于腰方肌阻滞组[(106.26±5.02)分vs.(103.26±6.22)分,P<0.05]。低位前锯肌组的不良反应发生率低于腰方肌阻滞组,差异有统计学意义[5.71%(4/70)vs.17.14%(12/70),P<0.05]。结论SAPB与QLB联合全身麻醉在腹腔镜下肾癌根治术中均能提供良好的麻醉效果,但SAPB在操作简便性、起效速度、患者恢复质量及安全性方面表现更优,是一种更为理想的麻醉选择。ObjectiveTo compare the anesthetic effect and subserratus anterior plane block(SAPB)and quadratus lumborum block(QLB)combined with general anesthesia in laparoscopic radical nephrectomy.MethodsThe clinical data of 140 patients with renal carcinoma in our hospital from January 2023 to October 2023 were retrospectively analyzed.According to the anesthesia method,the patients were divided into the low anterior serratus group(receiving the SAPB combined with general anesthesia)and the quadratus lumbosus block group(receiving the QLB combined with general anesthesia),with 70 cases in each group.The time of operation,time of onset,dosage of anesthesia,visual analog scale(VAS),quality of recovery score-15(QOR-15)and incidence of adverse reactions were analyzed in the two groups.ResultsThe operation time and onset time of block in low anterior serratus muscle group were shorter than those in quadratus lumbosus block group(all P<0.05).Two days after surgery,the QOR-15 score in the low anterior serratus muscle group was higher than that in the quadratus block group[(106.26±5.02)points vs.(103.26±6.22)points,P<0.05].The incidence of adverse reactions in the low anterior serratus group was lower than that in the quadratus lumbosus block group,and the difference was statistically significant[5.71%(4/70)vs.17.14%(12/70),P<0.05].ConclusionsSAPB and QLB combined with general anesthesia can provide good anesthetic effects in laparoscopic radical kidney cancer surgery,but SAPB is a more ideal anesthesia choice in terms of simplicity of operation,speed of onset,quality of patient recovery and safety.

关 键 词：肾肿瘤 腹腔镜检查 前锯肌平面阻滞 腰方肌阻滞 

分 类 号：R737.11[医药卫生—肿瘤]