布比卡因脂质体用于弓状韧带上腰方肌阻滞对胃癌根治术后镇痛效果及早期恢复质量的影响  

Effect of Bupivacaine Liposome on Analgesic Effect and Early Recovery Quality of Anterior Quadratus Lumborum Block at the Lateral Supra-Arcuate

作　　者：何鹏 林容木 章锐 陶志国[1] 夏晓琼[1] HE Peng;LIN Rongmu;ZHANG Rui;TAO Zhiguo;XIA Xiaoqiong(Department of Anesthesiology,Chaohu Hospital of Anhui Medical University,Chaohu 238000,Anhui,China)

机构地区：[1]安徽医科大学附属巢湖医院麻醉科,安徽巢湖238000

出　　处：《医学信息》2025年第5期94-98,共5页Journal of Medical Information

基　　金：2021年度安徽医科大学学科建设项目-麻醉学与药理学共建项目(编号:2021lcxk040)。

摘　　要：目的探讨布比卡因脂质体用于弓状韧带上腰方肌阻滞对胃癌根治术后镇痛及早期恢复质量的影响。方法选择2024年1月-5月于安徽医科大学附属巢湖医院择期行全麻腹腔镜胃癌根治术患者60例,采用随机数字表法将患者分为两组:罗哌卡因组(R)和布比卡因脂质体组(L),每组30例。R组给予0.375%罗哌卡因40 ml行弓状韧带上腰方肌阻滞联合全身麻醉,L组给予布比卡因脂质体266 mg共40 ml行弓状韧带上腰方肌阻滞联合全身麻醉。两组均接受常规气管插管全身麻醉。记录两组不同时间点(术后1、6、12、24、48、72 h)静息和活动(翻身)时VAS疼痛评分、手术时长,瑞芬太尼和丙泊酚总用量、首次下床时间、首次排气时间、首次进食时间、镇痛泵按压次数及补救镇痛例数、早期恢复质量、不良反应发生情况。结果L组术后6、12、24、48、72 h静息VAS评分及术后1、6、12、24、48、72 h运动VAS评分低于R组(P<0.05)。两组术后第7天QoR-15量表总评分比较,差异无统计学意义(P>0.05),而L组术后第1、3天QoR-15量表总评分高于R组(P<0.05);两组手术时长、瑞芬太尼和丙泊酚用量、住院时间、补救镇痛例数比较,差异无统计学意义(P>0.05),而L组术后首次下床时间、首次排气时间、首次进食时间短于R组,镇痛泵按压次数少于R组(P<0.05)。两组术后不良反应总发生率比较,差异无统计学意义(P>0.05)。结论布比卡因脂质体用于弓状韧带上腰方肌阻滞能够减轻腹腔镜胃癌根治术后疼痛,提高术后恢复质量,加速患者康复,其效果优于罗哌卡因。Objective To investigate the effect of bupivacaine liposome on postoperative analgesia and early recovery quality of anterior quadratus lumborum block at the lateral supra-arcuate ligament after radical gastrectomy.Methods Sixty patients undergoing laparoscopic radical gastrectomy under general anesthesia in Chaohu Hospital of Anhui Medical University from January to May 2024 were selected.The patients were divided into two groups by random number table method:ropivacaine(R)group and bupivacaine liposome(L)group,with 30 patients in each group.Group R was given 0.375%ropivacaine 40 ml for anterior quadratus lumborum block at the lateral supra-arcuate ligament combined with general anesthesia,and group L was given 266 mg bupivacaine liposome 40 ml for anterior quadratus lumborum block at the lateral supra-arcuate ligament combined with general anesthesia.Both groups received routine tracheal intubation general anesthesia.VAS pain score at rest and activity(turning over)at different time points(1,6,12,24,48,72 h after operation),operation time,total dosage of remifentanil and propofol,first time to get out of bed,first time to exhaust,first time to eat,number of times of analgesia pump pressing and number of remedial analgesia cases,early recovery quality and occurrence of adverse reactions were recorded.Results The VAS score of resting at 6,12,24,48 and 72 h after operation and exercise at 1,6,12,24,48 and 72 h after operation in group L was lower than that in group R(P<0.05).There was no significant difference in the total score of QoR-15 scale on the 7th day after operation between the two groups(P>0.05),while the total score of QoR-15 scale on the 1st and 3rd day after operation in group L was higher than that in group R(P<0.05).There was no significant difference in operation time,dosage of remifentanil and propofol,hospitalization time and number of remedial analgesia between the two groups(P>0.05),while the first time of getting out of bed,the first time of exhaust and the first time of eating in group L were

关 键 词：布比卡因脂质体 胃癌根治术 弓状韧带上腰方肌阻滞 术后镇痛 

分 类 号：R735.2[医药卫生—肿瘤]