超声引导下外侧弓状韧带上腰方肌前路阻滞复合全凭静脉麻醉在直肠癌腹腔镜手术患者中的应用  

Application of Ultrasound-guided Anterior Quadratus Lumborum Block at the Lateral Supra-arcuate Ligament Combined with Total Intravenous Anesthesia in Patients Undergoing Laparoscopic Surgery for Rectal Cancer

作　　者：黄进强[1] 梁万益[1] 邓铸强[1] HUANG Jinqiang;LIANG Wanyi;DENG Zhuqiang(Gaozhou People's Hospital,Gaozhou 525200,China;不详)

机构地区：[1]高州市人民医院,广东高州525200

出　　处：《中外医学研究》2024年第36期130-134,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨超声引导下外侧弓状韧带上腰方肌前路阻滞(QLB-LSAL)复合全凭静脉麻醉在直肠癌腹腔镜手术患者中的应用价值。方法:选取2022年1月—2024年1月高州市人民医院经全凭静脉麻醉腹腔镜手术治疗的50例直肠癌患者作为研究对象,纳入对照组;选取同期于医院经超声引导下QLB-LSAL复合全凭静脉麻醉腹腔镜手术治疗的50例直肠癌患者作为研究对象,纳入观察组。两组病历资料、手术资料等均保存完整。整理资料,记录并比较入室时、切皮时、缝合后30 min的血流动力学[平均动脉压(MAP)和心率(HR)]、术中麻醉药物量、术后恢复情况、术后疼痛程度[术后24 h的静息时、活动时的疼痛数字评分(NRS)结果]及不良反应情况。结果:两组切皮时MAP、HR均较入室时降低,于缝合后30 min均回升,但仍低于入室时,差异有统计学意义(P<0.05);观察组切皮时、缝合后30 min的MAP、HR均高于对照组,差异有统计学意义(P<0.05);观察组瑞芬太尼用量少于对照组,术后48 h镇痛泵按压次数少于对照组,首次排气时间、下床活动时间均短于对照组,差异有统计学意义(P<0.05);观察组静息时、活动时NRS评分均低于对照组,且药物相关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:超声引导下QLB-LSAL复合全凭静脉麻醉在直肠癌腹腔镜手术中应用,有助于稳定患者血流动力学,并能提供理想的术后镇痛,有利于患者术后机体功能恢复,且能减少瑞芬太尼用量,减少药物相关不良反应发生,提高手术整体的安全性。Objective:To explore the application value of ultrasound-guided anterior quadratus lumborum block at the lateral supra-arcuate ligament (QLB-LSAL) combined with total intravenous anesthesia in laparoscopic surgery for rectal cancer patients.Method:50 patients with rectal cancer who underwent laparoscopic surgery under total intravenous anesthesia in Gaozhou People's Hospital from January 2022 to January 2024,were selected as the study objects and included in the control group.50 patients with rectal cancer who underwent laparoscopic surgery under ultrasound-guided QLB-LSAL combined with total intravenous anesthesia in the hospital during the same period were selected as the study objects and included in the observation group.Patient medical records,surgical datas and other related materials were all kept intact.The patients' datas were collected,and the hemodynamics[mean arterial pressure (MAP) and heart rate (HR)],intraoperative anesthetic dosage,postoperative recovery,postoperative pain degree[numerical rating scale (NRS) results at rest and during activity 24 h after operation]and adverse reactions were recorded and compared at the time of entering the room,skin incision and 30 min after suture.Result:The MAP and HR of both groups of patients decreased during skin cutting compared to entering the room,and rebounded 30 minutes after suturing,but were still lower than those entering the room,with statistical significant differences (P<0.05).The MAP and HR of the observation group were higher than those of the control group during skin cutting and 30 minutes after suturing,with statistical significant differences (P<0.05).The dosage of remifentanil in the observation group was less than that in the control group,and the number of analgesic pump presses was less than that in the control group 48 hours after surgery,and first time to exhaust and the time to get out of bed were shorter than those in the control group,with statistical differences (P<0.05).The NRS scores of the observation group at rest and during act

关 键 词：直肠癌 腹腔镜 超声引导 外侧弓状韧带 腰方肌阻滞 全凭静脉麻醉 

分 类 号：R73[医药卫生—肿瘤]