摘要
目的:探讨分析超声引导下竖脊肌罗哌卡因平面阻滞对结直肠癌根治术后镇痛效果的影响。方法:选取2018年1月~2020年9月76例行腹腔镜下结直肠癌根治术的患者分为实验组和对照组,实验组给予超声引导下竖脊肌罗哌卡因平面阻滞,对照组不给予阻滞,直接进行麻醉诱导,比较两组术后不同时间点静息、动态VAS评分,术前、术后48h SRQ评分,术后镇痛指标,术后恢复指标。结果:静息状态实验组T0、T1、T2、T3、T4、T5、T6时间点VAS评分较对照组显著降低(P<0.05),动态时实验组T4、T5、T6时间点VAS评分较对照组显著降低(P<0.05),术前两组SRQ评分各维度评分差异无统计学意义(P>0.05),术后48 h实验组SRQ评分量表中情绪反应、躯体反应、行为反应评分下降更显著(P<0.05),术后48 h内实验组舒芬太尼使用量较对照组显著减少,补救性镇痛发生率显著降低,镇痛泵首次按压时间显著延长(P<0.05),术后实验组肛门排气时间、下床活动时间、停留尿管时间较对照组显著缩短(P<0.05),实验组不良反应发生率为5.26%较对照组21.05%显著降低(P<0.05)。结论:超声引导下竖脊肌平面阻滞应用于结直肠癌腹腔镜根治术中可减轻术后疼痛感,降低机体应激反应,减少术后麻醉药物使用量,降低不良反应发生率,改善生活质量。
Objective:To investigate and analyze the effect of ultrasound-guided erector spinae ropivacaine plane block on the analgesic effect after radical resection of colorectal cancer.Methods:From January 2018 to September 2020,76 patients undergoing laparoscopic radical resection of colorectal cancer were selected and divided into experimental group and control group.The experimental group was given ultrasound guided ropivacaine plane block of erector spinal muscle,while the control group was given no block and directly induced anesthesia.The two groups were compared at different time points after operation,including resting,dynamic VAS score,preoperative and postoperative 48 h SRQ score,postoperative analgesia index and postoperative recovery index.Results:VAS scores at time point T0,T1,T2,T3,T4,T5 and T6 in the resting state of the experimental group were significantly lower than those in the control group(P<0.05);VAS scores at time point T4,T5 and T6 in the dynamic state of the experimental group were significantly lower than those in the control group(P<0.05).There was no statistically significant difference in SRQ scores of each dimension between the two groups before surgery(P>0.05).The SRQ scores of the experimental group 48 h after surgery showed a more significant decrease in emotional response,physical response and behavioral response(P<0.05).Within 48 h after surgery,the dosage of sufentanil in the experimental group was significantly lower than that in the control group,the incidence of remedial analgesia was significantly reduced,and the duration of the first pressure of the analgesic pump was significantly prolonged(P<0.05).After operation,the time of anal exhaust,time of getting out of bed,and time of staying in the catheter in the experimental group were significantly shorter than those in the control group(P<0.05).The incidence of adverse reactions in the experimental group was significantly lower(5.26%)than that in the control group(21.5%).Conclusion:The application of ultrasonic guided erector spine muscle block in laparoscopic radical resection of colorectal cancer can reduce postoperative pain,stress response,the use of postoperative anesthetic drugs,and the incidence of adverse reactions,and improve the quality of life.
作者
王春宜
黄喜才
WANG Chunyi;HUANG Xicai(People's Hospital in Chenghai District of Shantou City,Shantou 515800,China)
出处
《包头医学院学报》
CAS
2020年第11期22-25,59,共5页
Journal of Baotou Medical College
关键词
超声引导
竖脊肌平面阻滞
结直肠癌
镇痛
Ultrasound guidance
Erector spinal muscle plane block
Colorectal cancer
Analgesia
