摘要
目的探讨超声引导下右美托咪定腹横肌平面阻滞在腹腔镜结直肠癌根治术患者中的应用效果。方法将我院收治的80例结直肠癌患者根据手术麻醉方案的不同分为观察组和对照组,各40例。麻醉诱导后,两组均行超声引导下腹横肌平面阻滞,其中观察组给予盐酸右美托咪定+罗哌卡因,对照组仅给予罗哌卡因。比较两组的麻醉效果。结果手术开始时(T_(2)),两组的收缩压(SBP)、舒张压(DBP)、心率(HR)低于麻醉诱导前(T_(0))、平面阻滞前(T_(1)),但观察组高于对照组(P<0.05);手术开始30 min(T_(3)),两组的SBP、DBP、HR高于T_(2),且观察组高于对照组(P<0.05)。观察组的不良反应总发生率低于对照组,术中丙泊酚、瑞芬太尼用量以及静脉自控镇痛(PICA)按压次数少于对照组(P<0.05)。T_(0)~T_(3)时,两组的皮质醇(Cor)水平呈递减趋势,且手术结束时(T_(4))的Cor水平高于T_(3)(P<0.05);T_(2)、T_(3)时,观察组的Cor水平高于对照组(P<0.05)。术后2、4、6 h,观察组的视觉模拟评分法(VAS)和Ramsay镇静评分低于对照组(P<0.05)。结论超声引导下右美托咪定腹横肌平面阻滞能有效降低术中瑞芬太尼和丙泊酚用量,维持患者生命体征平稳,减轻应激反应。
Objective To investigate the application effect of ultrasound-guided dexmedetomidine transversus abdominis plane block in patients undergoing laparoscopic radical resection of colorectal cancer.Methods Eighty patients with colorectal cancer admitted in our hospital were divided into observation group and control group according to different surgical anesthesia schemes,with 40 cases in each group.After anesthesia induction,ultrasound-guided transversus abdominis plane block was performed in both groups.The observation group was given dexmedetomidine hydrochloride+ropivacaine,and the control group was only given ropivacaine.The anesthetic effects of the two groups were compared.Results At the beginning of surgery(T_(2)),systolic blood pressure(SBP),diastolic blood pressure(DBP)and heart rate(HR)in the two groups were lower than those before anesthesia induction(T0)and before plane block(T_(1)),but those in the observation group were higher than the control group(P<0.05);at 30 min after the beginning of surgery(T_(3)),SBP,DBP and HR in the two groups were higher than those at T_(2),and those in the observation group were higher than the control group(P<0.05).The total incidence of adverse reactions in the observation group was lower than that in the control group,the dosage of propofol and remifentanil and the number of patient-controlled intravenous anqlgesia(PICA)compressions were less than those in the control group(P<0.05).At T0-T_(3),the corisol(Cor)level of the two groups showed a decreasing trend,and the Cor level at the end of surgery(T_(4))was higher than that at T_(3)(P<0.05);at T_(2) and T_(3),the Cor level in the observation group was higher than that in the control group(P<0.05).At 2,4,6 h after surgery,the Visual Analogue Scale(VAS)and Ramsay sedation scores of the observation group were lower than those of the control group(P<0.05).Conclusion Ultrasound-guided dexmedetomidine transversus abdominis plane block can effectively reduce the intraoperative dosage of remifentanil and propofol,maintain stable vital signs of patients,and reduce stress reactions.
作者
高永春
王宇
GAO Yongchun;WANG Yu(Yan'an People's Hospital,Yan'an 716000,China)
出处
《临床医学研究与实践》
2023年第22期117-120,共4页
Clinical Research and Practice
关键词
右美托咪定
结直肠癌根治术
腹横肌平面阻滞
dexmedetomidine
radical resection of colorectal cancer
transversus abdominis plane block
