星状神经节阻滞对腹腔镜下全子宫切除患者术后胃肠功能恢复的影响

Effect of stellate ganglion block on recovery of gastrointestinal function in patients undergoing laparoscopic total hysterectomy

目的观察星状神经节阻滞对腹腔镜下全子宫切除患者术后胃肠功能恢复的影响。方法全身麻醉下行腹腔镜全子宫切除术患者51例分为试验组(A组,26例)和对照组(C组,25例)。C组采用常规麻醉方案,A组麻醉前加行超声引导下星状神经节阻滞。记录两组术后胃肠功能恢复情况和不良反应发生情况。采用数字评定量表(NRS)、阿森斯失眠量表(AIS)和15项恢复质量评分量表(QoR-15)分别评估两组疼痛情况、睡眠质量和术后恢复情况。结果两组术后48 h内不同时间点NRS评分比较差异无统计学意义(P>0.05)。与C组比较,A组术后24 h排气发生率增高,首次经肛门排气时间缩短,腹胀和恶心呕吐发生率降低(P<0.01或P<0.05)。A组术后第1天AIS评分低于C组,而QoR-15评分高于C组(P<0.05)。结论术前加行星状神经节阻滞可缩短腹腔镜下全子宫切除患者术后胃肠功能恢复时间,降低术后胃肠道不良反应,改善患者睡眠质量。

Objective To explore the effect of stellate ganglion block(SGB)on the recovery of gastrointestinal function in the patients undergoing laparoscopic total hysterectomy.Methods A total of 51 patients undergoing laparoscopic total hysterectomy under general anesthesia were divided into two groups of A(26 cases)and C(25 cases).The conventional anesthesia was performed in group C,the ultrasound-guided SGB before anesthesia was additionally performed in group A.The recovery of gastrointestinal function and the occurrence of adverse responses in two groups were recorded.Pain status,sleep quality,and postoperative recovery were evaluated by numerical rating scale(NRS),Athens insomnia scale(AIS),and the quality of recovery-15 scale(QoR-15).Results There was no significant difference in NRS score between the two groups at different time points within 48 hours after surgery(P>0.05).Compared with group C,the incidence of exhaust 24 hours after surgery was increased,the first anal exhaust time was shortened,and the incidence of abdominal distension,nausea and vomiting within 48 hours after surgery was decreased in group A(P<0.01 or P<0.05).On the 1^(st)day after surgery,the AIS score was lower,while QoR-15 score was higher in group A than those in group C(P<0.05).Conclusion Additionally use of SGB before anesthesia can shorten the recovery time of gastrointestinal function,reduce postoperative gastrointestinal adverse responses and improve sleep quality in the patients undergoing laparoscopic total hysterectomy.