超声引导下腹横肌平面阻滞对腹腔镜下结肠癌根治术阻滞效果、应激反应和术后镇痛的影响

The Effect of Ultrasound Guided Horizontal Abdominal Muscle Block on the Blocking Effect,Stress Response and Postoperative Analgesia of Laparoscopic Colon Cancer Radical Operation

目的探讨超声引导下腹横肌平面阻滞对腹腔镜下结肠癌根治术阻滞效果、应激反应和术后镇痛的影响。方法选取行腹腔镜结肠癌根治术患者80例,根据治疗方案的不同分为对照组和实验组,各40例。对照组采用单纯全麻方式麻醉,实验组采用腹横肌阻滞辅助全麻方式麻醉,记录两种麻醉方法下患者的血流动力学和动脉血气并比较。结果与对照组相比,观察组PaO2、SPO2、血PH均显著增高,而PaCO2明显降低,差异具有统计学意义(P<0.05);两组患者MAP和HR值,在T0、T1时刻比较无统计学差异(P>0.05),在T2、T3、T4时刻比较,观察组均低于对照组,差异具有统计学意义(P<0.05)。结论在腹腔镜下结肠癌根治术中,采用超声引导下腹横肌平面阻滞可以缓解膈肌的过度兴奋,同时不抑制呼吸,很适合作为腹腔镜全麻的辅助手段,对于减少麻醉用药和应激反应具有明显的意义。

Objective To explore the effect of ultrasound-guided horizontal abdominal muscle block on the block effect,stress response and postoperative analgesia of laparoscopic radical resection of colon cancer.Methods 80 cases of laparoscopic colon cancer radical operation in our hospital were selected,According to the different treatment plan,the patients were divided into control group and experimental group,40 cases each.The control group was anesthetized by general anesthesia alone,and the experimental group was anesthetized by abdominal transverse muscle block assisted by general anesthesia.Results Compared with the control group,PaO2,SpO2 and blood pH in the observation group were significantly higher,However,PaCO2 was significantly reduced,The difference was statistically significant(P<0.05);There was no significant difference in map and HR between the two groups at t0 and T1(P>0.05),Compare at T2,T3 and T4,The observation group was lower than the control group,The difference was statistically significant(P<0.05).Conclusion In laparoscopic radical operation of colon cancer,the use of ultrasound-guided horizontal abdominal muscle block can alleviate the over excitation of diaphragm,but not inhibit respiration.It is very suitable as an auxiliary means of laparoscopic general anesthesia,which has obvious significance in reducing anesthetic drugs and stress response.