超声引导下神经阻滞联合静脉麻醉对宫颈癌患者的应用价值

Application values of ultrasound-guided nerve block combined with intravenous anesthesia in patients with cervical cancer

目的探讨超声引导下神经阻滞联合静脉麻醉对宫颈癌患者的应用价值。方法选取2018年6月至2021年4月间陕西省核工业二一五医院收治的行宫颈切除的68例早期宫颈癌患者,采用随机信封抽签原则分为研究组和对照组,每组34例。对照组患者采用静脉全身麻醉,研究组患者在对照组基础上采用超声引导下神经阻滞,比较两组患者疼痛程度、围手术期相关指标和并发症。结果两组患者手术时间、术中出血量和麻醉时间比较,差异无统计学意义(P>0.05)。研究组患者术后排气时间、术后拔除引流管时间和术后住院时间均短于对照组,差异均有统计学意义(均P<0.05)。研究组患者术后不同时间点的疼痛评分均低于对照组,差异均有统计学意义(均P<0.05)。两组患者术后4h、12h、24h的镇静评分比较,差异均无统计学意义(P>0.05)。研究组患者术后并发症总发生率为5.9%,低于对照组的35.3%,差异有统计学意义(P<0.05)。结论超声引导下神经阻滞联合静脉麻醉在宫颈癌患者术中应用,能更好发挥镇痛效应,减少不良反应,且不影响镇静效果,有利于患者康复。

Objective To explore the values of ultrasound-guided nerve block combined with intravenous anesthesia in patients with cervical cancer.Methods From June 2018 to April 2021,68 patients with early cervical cancer who underwent cervical resection were selected at No.215 Hospital of Shaanxi Nuclear Industry.They were divided into an experimental group and a control group with 34 patients in each group using random envelope drawing.The experimental group received ultrasound-guided nerve block combined with intravenous anesthesia and the control group received intravenous general anesthesia.Severity of pain,perioperative indicators and complications were compared between the two groups.Results There was no difference in the duration of operation,intraoperative bleeding and duration of anesthesia between the two groups(P>0.05).Time to postoperative exhaust,time to postoperative drainage tube removal and length of postoperative hospital stay shorter in the experimental group than in the control group(all P<0.05).The pain scores at different time points were lower in the experimental group than those in the control group(all P<0.05).There was no significant difference in Ramsay sedation scores at 4,12 and 24 h after operation between the two groups(P>0.05).The incidence of postoperative complications was 5.9%in the experimental group,which was lower than 35.3%of the control group(P<0.05).Conclusion Ultrasound-guided nerve block combined with intravenous anesthesia for cervical cancer surgery can result in better analgesic effect,reduce the occurrence of adverse reactions without affecting the sedation effects.