超声引导下星状神经节阻滞对妇科腹腔镜手术中脑氧合和术后胃肠功能恢复影响

The effect of ultrasound-guided stellate ganglion block on brain oxygenation during gynecological laparoscopic surgery and postoperative gastrointestinal function recovery

目的 观察妇科腹腔镜手术中应用超声引导下星状神经节阻滞的临床效果.方法 采用随机数字表法将东莞市长安医院70例在全身麻醉下行妇科腹腔镜手术患者分成对照组(35例)和观察组(35例),分别实施全身麻醉与全身麻醉+超声引导下星状神经节阻滞,对比两组脑氧合和术后胃肠功能恢复情况.结果 同对照组对比,观察组T_(1)、T_(2)时CEO_(2)均较低,rSO_(2)、SjvO_(2)较高;术毕至肠鸣音恢复时间、首次肛门排气与进食时间均较短;术后IL-4水平较低,IL-2水平较高;不良反应总发生率较低,差异均有统计学意义(P<0.05).结论 在全身麻醉下行妇科腹腔镜手术中实施超声引导下星状神经节阻滞,可改善脑氧合代谢,促进患者术后胃肠功能恢复,减轻机体免疫抑制,减少不良反应.

Objective To observe the clinical effect of ultrasound-guided stellate ganglion block in gynecological laparoscopic surgery.Methods A random number table method was used to divide 70 patients undergoing gynecological laparoscopic surgery under general anesthesia in our hospital into a control group(35 cases)and an observation group(35 cases),general anesthesia and general anesthesia+ultrasound-guided stellate ganglion block were performed respectively,and the cerebral oxygenation and postoperative gastrointestinal function recovery were compared between the two groups.Results Compared with the control group,the CEO,in the observation group was lower at T_(1),and T_(2),while rSO_(2) and SjvO_(2) were higher;the time from completion of surgery to recovery of intestinal sounds,as well as the time for first exhaust and eating,are relatively short;the postoperative IL-4 level is low,while the IL-2 level is high;the overall incidence of adverse reactions is relatively low,and the differences are statistically significant(P<0.05).Conclusion Ultrasound guided stellate ganglion block during gynecological laparoscopic surgery under general anesthesia can improve cerebral oxygenation metabolism,promote postoperative gastrointestinal function recovery,alleviate immune suppression,and reduce adverse reactions.