罗哌卡因腰方肌阻滞联合舒芬太尼静脉自控镇痛应用于直肠癌根治术的效果研究

Study on the Effect of Ropivacaine Quadratus Lumbar Muscle Block Combined with Sufentanil Intravenous Patientcontrolled Analgesia in Radical Resection of Rectal Cancer

目的:探讨罗哌卡因腰方肌阻滞联合舒芬太尼静脉自控镇痛应用于直肠癌根治术的效果。方法:选取2019年8月-2020年12月于本院行直肠癌根治术的130例患者,按照随机数字表法将其分为对照组和观察组,每组65例。观察组全麻诱导后给予罗哌卡因腰方肌阻滞,对照组不给予罗哌卡因腰方肌阻滞,两组术后均实施舒芬太尼静脉自控镇痛。比较两组疼痛评分(VAS)、麻醉和镇痛药物用量、免疫球蛋白(IgG、IgM)水平。结果:两组VAS评分均于术后2 h逐渐升高,术后12 h逐渐降低(P<0.05)。观察组术后6、12、24 h的VAS评分均低于对照组,差异均有统计学意义(P<0.05)。观察组术中芬太尼用量、术后舒芬太尼用量均少于对照组,差异均有统计学意义(P<0.05)。术前,两组IgG和IgM水平比较,差异均无统计学意义(P>0.05);术后24 h,两组IgG和IgM水平均低于术前,且对照组均低于观察组,差异均有统计学意义(P<0.05)。结论:罗哌卡因腰方肌阻滞联合舒芬太尼静脉自控镇痛用于直肠癌根治术能明显提高镇痛效果,减少阿片类药物用量,并有效减轻患者免疫抑制。

Objective:To explore the effect of Ropivacaine quadratus lumbar muscle block combined with Sufentanil intravenous patient-controlled analgesia in radical resection of rectal cancer.Method:A total of 130 patients undergoing radical rectal cancer surgery in our hospital from August 2019 to December 2020 were selected,and they were divided into control group and observation group according to random number table method,65 cases in each group.The observation group was given Ropivacaine quadratus lumbar muscle block after induction of general anesthesia,while the control group was not given Ropivacaine quadratus lumbar muscle block.Sufentanil intravenous patient-controlled analgesia was administered after surgery in both groups.The pain score (VAS),the dosage of anesthesia and analgesia,and the levels of immunoglobulin (IgG,IgM) before and after surgery were compared between two groups.Result:The VAS scores in both groups increased gradually 2 h after surgery,and decreased gradually 12 h after surgery (P<0.05).6,12 and 24 h after surgery,VAS scores in the observation group were lower than those in the control group,the differences were statistically significant (P<0.05).The dosage of intraoperative Fentanyl and postoperative Sufentanil in the observation group were lower than those in the control group,the differences were statistically significant (P<0.05).Before surgery,there were no significant differences in IgG and IgM levels between two groups (P>0.05);24 h after surgery,IgG and IgM levels in both groups were lower than those before surgery,and those in the control group were lower than those in the observation group,the differences were statistically significant (P<0.05).Conclusion:Ropivacaine quadratus lumbar muscle block combined with Sufentanil intravenous patient-controlled analgesia for radical resection of rectal cancer can improve the analgesic effect,reduce the dosage of opioids,and effectively reduce the patients’ immunosuppression.