腰方肌阻滞复合全身麻醉在老年腹腔镜胆囊切除术中的麻醉效果观察  

Observation of anesthesia effect of lumbar quadratus muscle block combined with general anesthesia in elderly laparoscopic cholecystectomy

作　　者：史庆超 刘晓刚 Shi Qing-chao;Liu Xiao-gang(Department of Anesthesiology,Puyang Huimin Hospital,Puyang 457000,Henan,China)

机构地区：[1]濮阳惠民医院麻醉科,河南濮阳457000

出　　处：《四川生理科学杂志》2025年第3期630-633,共4页

摘　　要：目的:观察腰方肌阻滞复合全身麻醉在老年腹腔镜胆囊切除术中的麻醉效果。方法:选取2022年3月至2023年9月于我院接受腹腔镜胆囊切除术的68例老年患者作为研究对象,根据随机数字表法分为对照组和观察组,各34例。对照组采用全身麻醉,观察组采用腰方肌阻滞复合全身麻醉。比较两组心率、血压(舒张压和收缩压)、术中麻醉情况、麻醉后恢复情况(胃肠道功能相关指标和下床活动时间)、术后疼痛程度[视觉模拟评分法(Visual analogue scale,VAS)]、术后舒适度[布鲁格曼舒适度量表(Bruggeman comfort scale,BCS)]和不良反应发生情况。结果:术后6 h,观察组的舒张压、收缩压均心率明显低于对照组(P<0.05);观察组舒芬太尼用量和丙泊酚用量明显少于对照组,手术时间明显短于对照组(P<0.05);观察组肠鸣音恢复时间、饮食时间、排气时间、排便时间、下床活动时间明显短于对照组(P<0.05);观察组术后BCS评分明显高于对照组,VAS评分明显低于对照组(P<0.05);观察组不良反应发生率明显低于对照组(P<0.05)。结论:老年腹腔镜胆囊切除术患者施行腰方肌阻滞复合全身麻醉,有利于减轻应激反应和术后疼痛,减少麻醉药物用量,缩短手术时间,促进患者胃肠功能恢复,提高术后舒适度,减少不良反应发生,值得推广应用。Objective:To observe the anesthesia effect of lumbar quadratus muscle block combined with general anesthesia in elderly laparoscopic cholecystectomy.Methods:A total of 68 elderly patients who underwent laparoscopic cholecystectomy in our hospital from March 2022 to September 2023 were divided into a control group and an observation group using a random number table method,with 34 cases in each group.The control group received general anesthesia,while the observation group received lumbar quadratus muscle block combined with general anesthesia.The heart rate,blood pressure(diastolic pressure and systolic pressure),anesthesia situation,the recovery after anesthesia(the gastrointestinal function related indicators and the time to get out of bed),postoperative pain level[Visual Analog Scale(VAS)],postoperative comfort[Brugman Comfort Scale(BCS)]and incidence of adverse reactions between two groups were compared.Results:The heart rate of diastolic blood pressure and systolic blood pressure in observation group was lower than that in control group at 6h after operation(P<0.05).The dosage of sufentanil and propofol in the observation group was lower than that in the control group,and the surgical time was shorter than that in the control group(P<0.05);The gastrointestinal function related indicators in the observation group were better than those in the control group,and the time of getting out of bed was shorter than that in the control group(P<0.05);The postoperative BCS score of the observation group was higher than that of the control group,while the VAS score was lower than that of the control group(P<0.05);The incidence of adverse reactions in the observation group was lower than that in the control group(P<0.05).Conclusion:The use of lumbar quadratus muscle block combined with general anesthesia in elderly patients undergoing laparoscopic cholecystectomy is beneficial for reducing stress reactions and postoperative pain,reducing the dosage of anesthetic drugs,shortening surgical time,promoting gastrointestinal fu

关 键 词：老年腹腔镜胆囊切除术 腰方肌阻滞 全身麻醉 麻醉效果 

分 类 号：R47[医药卫生—护理学]