不同麻醉镇痛方式对腹腔镜结直肠癌根治术患者术后转归的影响

Effects of different anesthesia methods on postoperative outcome of patients undergoing laparoscopic radical resection of colorectal cancer

目的分析采用不同麻醉镇痛方式对腹腔镜结直肠癌根治术患者术后转归的影响。方法回顾性分析2019年1月—2020年6月期间收治的90例行腹腔镜结直肠癌根治术的患者,将2019年1月—2019年6月期间收治的30例患者归为静脉镇痛组,给予全身麻醉联合静脉镇痛;将2019年7月—2019年12月期间收治的30例患者归为硬膜外镇痛组,给予全身麻醉联合硬膜外镇痛;将2020年1月—2020年6月期间收治的30例患者归为腹横肌平面阻滞组,给予全身麻醉联合腹横肌平面阻滞。对比三组的自主呼吸恢复时间、苏醒时间、拔除气管时间、胃肠道恢复时间、疼痛程度。结果术毕,硬膜外镇痛组与腹横肌平面阻滞组的自主呼吸恢复时间、苏醒时间、拔除气管时间、胃肠道恢复时间均短于静脉镇痛组(P<0.05);术后4 h、术后6 h、术后12 h,硬膜外镇痛组与腹横肌平面阻滞组的视觉模拟评分法(VAS)评分均低于静脉镇痛组(P<0.05)。结论全身麻醉联合硬膜外镇痛或者腹横肌平面阻滞组有利于行腹腔镜结直肠癌根治术患者术后转归,同时可以改善疼痛。

Objective To analyze the effects of different anesthesia methods on postoperative outcome of patients with laparoscopic radical resection of colorectal cancer.Methods A retrospective analysis was performed on 90 patients undergoing laparoscopic radical resection of colorectal cancer admitted from January 2019 to June 2020.Among them,30 patients admitted from January 2019 to June 2019 were selected as intravenous analgesia group and given general anesthesia combined with intravenous analgesia;30 patients admitted from July 2019 to December 2019 as epidural analgesia group and given general anesthesia combined with epidural analgesia;and 30 patients admitted from January 2020 to June 2020 as transversus abdominis plane block group and given general anesthesia combined with transversus abdominis plane block.The time of spontaneous breathing recovery,eye opening,tracheal removal,and gastrointestinal tract recovery,and the pain degree of the three groups were compared.Results After the operation,the spontaneous breathing recovery time,eye opening time,tracheal removal time,and gastrointestinal recovery time of the epidural analgesia group and the transversus abdominis plane block group were shorter than those of the intravenous analgesia group(P<0.05).At postoperative 4 h,6 h,and 12 h,the VAS scores of the epidural analgesia group and the transversus abdominis plane block group were lower than those of the intravenous analgesia group(P<0.05).Conclusion General anesthesia combined with epidural analgesia or transversus abdominis plane block is beneficial to the postoperative outcome of patients undergoing laparoscopic radical resection of colorectal cancer,and reduce pain as well.