超声引导下星状神经节阻滞复合全凭静脉麻醉在早期胃癌手术患者中的应用

Application of ultrasound-guided stellate ganglion block combined with total intravenous anesthesia in patients with early gastric cancer

目的 观察早期胃癌手术患者采用超声引导下星状神经节阻滞(SGB)复合全凭静脉麻醉的临床效果。方法 选取2019年1月至2021年1月南阳市第一人民医院接受手术治疗的82例早期胃癌患者为研究对象,依据住院病历号将其分为对照组与观察组各41例。对照组采用全凭静脉麻醉,观察组采用SGB复合全凭静脉麻醉。对比两组患者不同时间(麻醉前、麻醉诱导后、切皮时、手术结束时)收缩压(SBP)、舒张压(DBP)、心率(HR),并比较两组拔管后1 h、拔管后6 h和拔管后12 h时疼痛程度[视觉模拟评分法(VAS)]。结果 麻醉诱导后、切皮时、手术结束时,两组SBP、DBP、HR水平持续升高,但观察组低于对照组,两组组间、时点、组间与时点交叉比较,差异有统计学意义(P<0.05);拔管后1 h、拔管后6 h时,两组VAS评分持续升高,拔管12 h时两组VAS评分降低,拔管后1 h、6 h、12 h观察组VAS评分均低于对照组,两组组间、时点、组间与时点交叉比较,差异有统计学意义(P<0.05)。结论 SGB复合全凭静脉麻醉可维持早期胃癌手术患者术中血压及心率水平,减轻术后疼痛程度。

【Objective】 To observe the clinical effect of ultrasound-guided stellate ganglion block(SGB) combined with total intravenous anesthesia in patients with early gastric cancer. 【Methods】 Eighty-two patients with early gastric cancer who received surgical treatment in Nanyang First People’s Hospital from January 2019 to January 2021 were selected as the research subjects.According to the inpatient medical record number, they were divided into control group(41 cases) and observation group(41 cases).The control group was treated with total intravenous anesthesia, and the observation group was treated with ultrasound-guided SGB combined with total intravenous anesthesia. Systolic blood pressure(SBP), diastolic blood pressure(DBP) and heart rate(HR) were compared between the two groups at different times(before anesthesia, after anesthesia induction, during skin incision and at the end of operation), and the degree of pain [Visual Analogue Scale(VAS)] before operation, 1 hour after extubation and 6 hours after extubation were compared between the two groups. 【Results】 The levels of SBP, DBP and HR in both groups were increased continuously after anesthesia induction, at skin incision and the end of operation, but the observation group was lower when compared with the control group, compared among groups, time points, and interactively between groups and time points, the differences were statistically significant(F=33.638, 23.687, 3.688, 13.422, 28.146, 3.279, 18.385, 39.683, 5.837, all P<0.05);1 hour and 6 hours after extubation, the VAS scores of both groups continued to increase, 12 hours after extubation, the VAS scores of both groups were decreased, and 1 hour, 6 hours and 12 hours after extubation, the VAS scores of the observation group were lower than those of the control group, compared among groups, time points, and interactively between groups and time points, the differences were statistically significant(F=165.482, 73.589, 5.511, P<0.05). 【Conclusion】 Ultrasound-guided SGB combined with total intravenous anesthesia can maintain the intraoperative blood pressure and heart rate level of patients with early gastric cancer and reduce the degree of postoperative pain.