全麻联合腹横肌平面阻滞与硬膜外阻滞在腹腔镜结直肠癌手术中的应用效果

Effect of anesthesia combined with epidural block or transverse abdominal plane block on anesthesia in laparoscopic colorectal cancer surgery

目的比较连续腹横肌平面阻滞与硬膜外阻滞联合麻醉在腹腔镜结直肠癌手术中的应用效果。方法随机将2018年8月—2019年7月医院行腹腔镜结直肠癌手术患者分为对照组和研究组。对照组采取全麻联合连续腹横肌平面阻滞麻醉,研究组采取全麻联合硬膜外阻滞麻醉。比较术后患者恢复情况及不良反应发生率;评估术后疼痛程度;检测术前术后超氧化物歧化酶(SOD)和丙二醇(MDA)等氧化应激指标。结果研究组患者首次肛门排气时间,首次进食时间和首次下床活动时间均显著低于对照组(P<0.05)。研究组患者术后疼痛及氧化应激指标变化程度均显著低于对照组(P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论与连续腹横肌平面阻滞相比,硬膜外阻滞联合全麻更有助于提高腹腔镜结直肠癌手术患者整体镇痛效果,减轻氧化应激反应,促进患者早日康复。

Objective To compare the effect of anesthesia combined with epidural block or transverse abdominal plane block in laparoscopic colorectal cancer surgery.Methods Patients undergoing laparoscopic colorectal cancer surgery in our Hospital from August 2018 to July 2019 were randomly divided into control group and study group.The control group received general anesthesia combined with transverse abdominal plane block,and the study group received general anesthesia combined with epidural block.The recovery and the incidence of adverse reactions were compared.The degree of postoperative pain was evaluated.The oxidative stress indexes such as superoxide dismutase(SOD)and maleic dialdehyde(MDA)were measured before and after operation.Results The first time of anal exhaust,first time of eating and first time of activity after getting out of bed in the study group were significantly lower than those in the control group(P<0.05).The degree of postoperative pain and the changes of oxidative stress index in the study group were significantly lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Compared with continuous transrerse abdominal plane block,epidural block combined with general anesthesia is more helpful to improve the overall analgesic effect of laparoscopic colorectal cancer surgery,reduce oxidative stress index,and promote the early recovery of patients.