超声引导腰方肌阻滞技术在腹腔镜直肠癌根治术中的应用

Application of Ultrasound-guided Quadrate Block Technique in Laparoscopic Radical Resection of Rectal Cancer

目的 探讨超声引导腰方肌阻滞技术在腹腔镜直肠癌根治术中的应用价值。方法 随机选取2022年1月—2023年9月寿光市人民医院择期实施的全身麻醉气管插管下腹腔镜直肠癌根治术80例。按照随机数表法分为对照组和研究组,各40例。对照组行气管插管全身麻醉,观察组则在对照组基础上,于全身麻醉诱导前实施超声引导下腰方肌阻滞术,比较两组术后12 h疼痛视觉评分(Numerical Ratings Scale,NRS)评分及血清致痛物质(Pain-causing substance,SP)水平变化,分析两组麻醉苏醒指标,统计两组麻醉复苏阶段并发症发生情况。结果 观察组术后12 h NRS评分为(2.7±0.3)分,低于对照组,差异有统计学意义(t=13.016,P<0.05);观察组SP水平低于对照组,差异有统计学意义(P<0.05);观察组呼之睁眼、气管导管拔管及复苏室停留时间均短于对照组,差异有统计学意义(P<0.05);观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论 针对腹腔镜直肠癌根治术患者,在全身麻醉诱导前实施超声引导下腰方肌阻滞,可有效的降低围术期患者疼痛,促进麻醉复苏,减少麻醉相关并发症发生率。

Objective To investigate the value of ultrasound-guided quadrate block technique in laparoscopic radical resection of rectal cancer.Methods A total of 80 cases of laparoscopic radical resection of rectal cancer under general anesthesia and tracheal intubation were randomly selected from Shouguang People's Hospital from January 2022 to September 2023.According to the method of random number table,they were divided into control group and observation group,with 40 cases in each group.The control group received tracheal intubation general anesthesia,and the observation group received ultrasound-guided quadrate block before general anesthesia induction.Numerical Ratings Scale(NRS) scores and serum Pain-causing substance(SP) levels were compared between the two groups at 12 hours after surgery,the indexes of anesthesia recovery were analyzed,and the incidence of complications at the stage of anesthesia recovery in the two groups were statistically analyzed.Results The NRS score of the observation group was(2.7±0.3) points at 12 hours after operation,which was lower than that of the control group,and the difference was statistically significant(t=13.016,P<0.05).The SP level of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).The stay time of eye opening,tracheal catheter extubation and resuscitation room in observation group were shorter than those in control group,and the differences were statistically significant(P<0.05).The incidence of complications in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion For patients undergoing laparoscopic radical resection of rectal cancer,ultrasound-guided low back quadrate block before general anesthesia induction can effectively reduce perioperative pain,promote anesthesia recovery,and reduce the incidence of anesthesia-related complications.