星状神经节阻滞在老年胃癌腹腔镜根治术麻醉中的应用效果

Application Effect of Stellate Ganglion Block in Anesthesia of Laparoscopic Radical Surgery for Elderly Gastric Cancer

目的:探讨星状神经节阻滞在老年胃癌腹腔镜根治术麻醉中的应用效果。方法:选取2019年6月—2020年6月于济南市人民医院和济南市第二妇幼保健院行腹腔镜根治术治疗的112例老年胃癌患者作为研究对象,以随机数字表法分为观察组和对照组,各56例。对照组在气管旁第6颈椎横突入路,注射0.9%氯化钠注射液10 mL,然后行全身麻醉。观察组经超声引导行星状神经节阻滞(SGB),然后行全身麻醉。比较两组麻醉效果。结果:气管插管前,两组心率和平均动脉压比较,差异无统计学意义(P>0.05);气管插管时、气管插管后3 min、拔管时,观察组心率和平均动脉压低于对照组,差异有统计学意义(P<0.05)。术前1 d,两组简易智能精神状态检查量表(MMSE)评分比较,差异无统计学意义(P>0.05);麻醉复苏后1 h、1 d、3 d、7 d,观察组MMSE评分高于对照组,差异有统计学意义(P<0.05)。结论:星状神经节阻滞在老年胃癌腹腔镜根治术麻醉中的应用效果较好,能够稳定患者术中生命体征,且术后认知功能恢复快。

Objective:To investigate the application effect of stellate ganglion block in the anesthesia of laparoscopic radical surgery for elderly gastric cancer.Methods:A total of 112 elderly patients with gastric cancer who received laparoscopic radical surgery in Jinan City People's Hospital and the Second Children and Women's Healthcare of Jinan City from June 2019 to June 2020 were selected as the study subjects.They were divided into observation group and control group according to random number table method,with 56 cases in each group.The control group was injected with 10 mL of 0.9%sodium chloride injection via the paratracheal transverse process of the 6th cervical vertebra,followed by general anesthesia.The observation group was given ultrasound-guided stellate ganglion block(SGB),followed by general anesthesia.The anesthesia effects of two groups were compared.Results:Before tracheal intubation,there was no significant difference in heart rate and mean arterial pressure between the two groups(P>0.05);During endotracheal intubation,at 3 min after endotracheal intubation,and during extubation,the heart rate and mean arterial pressure in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05).On 1 d before operation,there was no significant difference in the scores of Mini-Mental State Examination(MMSE)between the two groups(P>0.05);At 1 h and on 1 d,3 d,and 7 d after anesthesia resuscitation,the MMSE scores in the observation group were higher than those in the control group,and the difference was statistically significant(P<0.05).Conclusion:Stellate ganglion block has good application effects in the anesthesia of laparoscopic radical surgery for elderly gastric cancer,and can stabilize the intraoperative vital signs of patients,and has rapid postoperative recovery of cognitive function.