Electromyographic study of shoulder and acromioclavicular joint muscles in women who underwent unilateral breast surgery of the types mastectomy and quadrantectomy

We studied 20 women with mean age 57.7 years, being 9 with unilateral quadrantectomy surgery, 1 with surgery type bilateral quadrantectomy and 10 with unilateral mastectomy surgery. The average operative time was 9.8 (nine years and eight months). We studied using surface electromyography the mean deltoid, upper trape-zius and latissimus dorsi muscles in order to check the action potentials of these muscles when performing a sequence of movements of these joints. It was used for the study, an Acquisition Data System ADS1000 containing 12 channels. The electromyography (EMG) results expressed in RMS (Root Mean Square) were analyzed and compared between the surgical and nonsurgical side, among the three repetitions of the sequence of movements and between mastectomy and quadrantectomy for each muscle. For statistical analysis we used analysis of variance (ANOVA) with a double repetition factor

The Suh Muscle Hook: A New Muscle Hook for Tight Extraocular Muscles during Strabismus Surgery

Purpose: To introduce an advanced muscle hook to decrease risks and create more feasible extraocular muscle surgeries for physicians. Case Report: Tight extraocular muscles during strabismus surgery could be extremely challenging even in experienced hands due to restricted globe rotation, limited view, and lack of muscle elasticity. Although a variety of surgical instruments have been introduced through the years, traditional muscle hooks such as the Jameson hook are largely unchanged and are bulky and cumbersome. Using the traditional muscle hook under situations such as pediatric strabismus surgery with smaller eyes and extraocular muscles may increase the risk of perforating the globe or even rupturing the muscles. We developed the “Suh muscle hook”, which has a 0.55 mm wide grooved track in a 1.1 mm wide horizontal bar, a semi-sharp dissecting tip, and a 30-degree bending near the handle accommodating for nasal bridge to better facilitate surgeons dealing with tight extraocular muscles and minimize risks during strabismus surgery.

Sonographic muscle mass assessment in patients after cardiac surgery

BACKGROUND Patients undergoing cardiac surgery particularly those with comorbidities and frailty,experience frequently higher rates of post-operative morbidity,mortality and prolonged hospital length of stay.Muscle mass wasting seems to play important role in prolonged mechanical ventilation(MV)and consequently in intensive care unit(ICU)and hospital stay.AIM To investigate the clinical value of skeletal muscle mass assessed by ultrasound early after cardiac surgery in terms of duration of MV and ICU length of stay.METHODS In this observational study,we enrolled consecutively all patients,following their admission in the Cardiac Surgery ICU within 24 h of cardiac surgery.Bedside ultrasound scans,for the assessment of quadriceps muscle thickness,were performed at baseline and every 48 h for seven days or until ICU discharge.Muscle strength was also evaluated in parallel,using the Medical Research Council(MRC)scale.RESULTS Of the total 221 patients enrolled,ultrasound scans and muscle strength assessment were finally performed in 165 patients(patients excluded if ICU stay<24 h).The muscle thickness of rectus femoris(RF),was slightly decreased by 2.2%[(95%confidence interval(CI):-0.21 to 0.15),n=9;P=0.729]and the combined muscle thickness of the vastus intermedius(VI)and RF decreased by 3.5%[(95%CI:-0.4 to 0.22),n=9;P=0.530].Patients whose combined VI and RF muscle thickness was below the recorded median values(2.5 cm)on day 1(n=80),stayed longer in the ICU(47±74 h vs 28±45 h,P=0.02)and remained mechanically ventilated more(17±9 h vs 14±9 h,P=0.05).Moreover,patients with MRC score≤48 on day 3(n=7),required prolonged MV support compared to patients with MRC score≥49(n=33),(44±14 h vs 19±9 h,P=0.006)and had a longer duration of extracorporeal circulation was(159±91 min vs 112±71 min,P=0.025).CONCLUSION Skeletal quadriceps muscle thickness assessed by ultrasound shows a trend to a decrease in patients after cardiac surgery post-ICU admission and is associated with prolonged duration of MV and ICU length of stay.

Atrophy and Fibrosis of Extra-Ocular Muscles in Anti-Acetylcholine Receptor Antibody Myasthenia Gravis

Myasthenia gravis (MG) is an autoimmune disorder involving the neuromuscular junction that frequently affects the extra-ocular muscles (EOMs). It has been described as a very rare cause of bilateral EOM atrophy, but histological analysis of such cases is lacking. A 66-year-old man presented with two months of right eyelid drooping and vertical diplopia. Examination showed bilateral ophthalmoparesis and complete right ptosis. The remainder of his exam was normal, and an MRI showed small EOMs. Acetylcholine receptor antibodies were elevated, establishing the diagnosis of MG. Oral corticosteroids and pyridostigmine followed by azathioprine improved his ptosis, but not his ophthalmoparesis. One year later he had surgical correction of his diplopia, and the resected superior rectus muscle showed complete replacement of EOM by connective tissue. MG can rarely cause bilateral EOM atrophy, which is characterized histologically by fibrosis in the muscle itself. Atrophy in the EOMs of a myasthenic patient may indicate a poor response to medical management alone.

Perioperative respiratory muscle training improves respiratory muscle strength and physical activity of patients receiving lung surgery:A meta-analysis

BACKGROUND The clinical role of perioperative respiratory muscle training(RMT),including inspiratory muscle training(IMT)and expiratory muscle training(EMT)in patients undergoing pulmonary surgery remains unclear up to now.AIM To evaluate whether perioperative RMT is effective in improving postoperative outcomes such as the respiratory muscle strength and physical activity level of patients receiving lung surgery.METHODS The PubMed,EMBASE(via OVID),Web of Science,Cochrane Library and Physiotherapy Evidence Database(PEDro)were systematically searched to obtain eligible randomized controlled trials(RCTs).Primary outcome was postoperative respiratory muscle strength expressed as the maximal inspiratory pressure(MIP)and maximal expiratory pressure(MEP).Secondary outcomes were physical activity,exercise capacity,including the 6-min walking distance and peak oxygen consumption during the cardio-pulmonary exercise test,pulmonary function and the quality of life.RESULTS Seven studies involving 240 participants were included in this systematic review and meta-analysis.Among them,four studies focused on IMT and the other three studies focused on RMT,one of which included IMT,EMT and also combined RMT(IMT-EMT-RMT).Three studies applied the intervention postoperative,one study preoperative and the other three studies included both pre-and postoperative training.For primary outcomes,the pooled results indicated that perioperative RMT improved the postoperative MIP(mean=8.13 cmH_(2)O,95%CI:1.31 to 14.95,P=0.02)and tended to increase MEP(mean=13.51 cmH_(2)O,95%CI:-4.47 to 31.48,P=0.14).For secondary outcomes,perioperative RMT enhanced postoperative physical activity significantly(P=0.006)and a trend of improved postoperative pulmonary function was observed.CONCLUSION Perioperative RMT enhanced postoperative respiratory muscle strength and physical activity level of patients receiving lung surgery.However,RCTs with large samples are needed to evaluate effects of perioperative RMT on postoperative outcomes in patients undergoing lung surgery.

Anterior segment optical coherence tomography for identifying muscle status in strabismus surgery

Anterior segment optical coherence tomography （AS-OCT） finds very few indications in the domain of strabismus surgery. Current applications remain restricted to determining limbus-muscle insertion distance and anterior segment changes after strabismus surgery. We discuss two cases of operated strabismus surgery where AS-OCT imaging helped in identifying the operated eye and/or extra ocular muscles （EOM） and thus proved instrumental in planning and management.

Effect of preoperative inspiratory muscle training on postoperative outcomes in patients undergoing cardiac surgery:A systematic review and meta-analysis

BACKGROUND Cardiovascular disease is the most prevalent disease worldwide and places a great burden on the health and economic welfare of patients.Cardiac surgery is an important way to treat cardiovascular disease,but it can prolong mechanical ventilation time,intensive care unit(ICU)stay,and postoperative hospitalization for patients.Previous studies have demonstrated that preoperative inspiratory muscle training could decrease the incidence of postoperative pulmonary complications.AIM To explore the effect of preoperative inspiratory muscle training on mechanical ventilation time,length of ICU stay,and duration of postoperative hospitalization after cardiac surgery.METHODS A literature search of PubMed,Web of Science,Cochrane Library,EMBASE,China National Knowledge Infrastructure,WanFang,and the China Science and Technology journal VIP database was performed on April 13,2022.The data was independently extracted by two authors.The inclusion criteria were:(1)Randomized controlled trial;(2)Accessible as a full paper;(3)Patients who received cardiac surgery;(4)Preoperative inspiratory muscle training was implemented in these patients;(5)The study reported at least one of the following:Mechanical ventilation time,length of ICU stay,and/or duration of postoperative hospitalization;and(6)In English language.RESULTS We analyzed six randomized controlled trials with a total of 925 participants.The pooled mean difference of mechanical ventilation time was-0.45 h[95%confidence interval(CI):-1.59-0.69],which was not statistically significant between the intervention group and the control group.The pooled mean difference of length of ICU stay was 0.44 h(95%CI:-0.58-1.45).The pooled mean difference of postoperative hospitalization was-1.77 d in the intervention group vs the control group[95%CI:-2.41-(-1.12)].CONCLUSION Preoperative inspiratory muscle training may decrease the duration of postoperative hospitalization for patients undergoing cardiac surgery.More high-quality studies are needed to confirm our conclusion.

Review of the literature laparoscopic surgery for metastatic hepatic leiomyosarcoma associated with smooth muscle tumor of uncertain malignant potential: Case report

Metastatic hepatic leiomyosarcoma is a rare malignant smooth muscle tumor.We report a case of metastatic hepatic leiomyosarcoma associated with smooth muscle tumor of uncertain malignant potential(STUMP).A 68-year-old female presented with a liver mass(60 mm × 40 mm, Segment 4).She underwent left salpingooophorectomy for an ovary tumor with STUMP in a broad ligament 6 years ago.Though FDG-PET showed obvious metabolically active foci, abnormal metabolically active foci other than the lesion were not detected.A malignant liver tumor was strongly suspected and laparoscopic partial liver resection was performed with vessel-sealing devices using the crush clamping method and Pringle maneuver.Immunohistochemical findings revealed metastatic liver leiomyosarcoma associated with STUMP in a broad ligament.This case is an extremely rare case of malignant transformation from primary STUMP to metastatic hepatic leiomyosarcoma.It provides important evidence regarding the treatment for metastatic hepatic leiomyosarcoma associated with STUMP.

Evaluation of nintedanib as a new postoperative antiscarring agent in experimental extraocular muscle surgery

AIM:To investigate the efficacy of nintedanib on reducing postoperative inflammation,fibrosis and adhesion formation following extraocular muscle surgery in rabbits in comparison with triamcinolone acetonide(TA).METHODS:Reinsertion of superior rectus muscle in right eyes of 30 New Zealand white rabbits were performed.They were randomized to receive one of the following treatments:0.9%normal saline,one of 1-,5-,and 10μmol doses of nintedanib subconjunctivally immediately after surgery and on postoperative day 1,2,3,5,and 7,and TA immediately after surgery.As a control group,unoperated left eyes(n=6)were used.On the 28 th day,six eyes from each group were enucleated and histopathologically and immunohistochemically analyzed to assess the postoperative inflammatory changes,fibrosis and adhesion.Transforming growth factor beta,matrix metalloproteinase-2 and alpha smooth muscle actin expressions were evaluated.RESULTS:Conjunctival and scleral inflammation in TA and nintedanib groups were significantly reduced compared to saline(sham)group.Conjunctival vascularity and rectus muscle fibrosis were significantly reduced in 10μmol nintedanib group.Nintedanib groups were the most effective groups in reduction of perimuscular fibrosis.Neither three nintedanib groups nor TA group differed statistically from sham group with regard to adhesion.The expressions of transforming growth factor beta,alpha smooth muscle actin and matrix metalloproteinase-2 were reduced in nintedanib groups compared to saline group.CONCLUSION:Nintedanib appears to attenuate postoperative inflammation and fibrosis after extraocular muscle surgery.Nintedanib may be a safer and stronger alternative agent in extraocular muscle surgery when compared to steroids.Further investigation is needed to prove antiadhesive effect of nintedanib.

The value of abnormal muscle response monitoring during microvascular decomprssion surgery for hemifacial spasm

Objective Abnormal muscle response (AMR) to the electrical stimulation of a branch of facial nerve is a specific electrophysiological feature of primary hemifacial spasm (HFS) . Although the correlation between intraoperative AMR findings and postoperative results in patients with HFS were investigated before,

胸腔镜与Muscle-Sparing开胸肺叶切除术的临床比较

目的比较胸腔镜与Muscle-Sparing开胸肺叶切除术的临床结果。方法56例行肺叶切除术的患者,分为胸腔镜辅助肋间切口(VAMT)肺叶切除术(VAMT组)20例和微创Muscle-sparing开胸(MST)肺叶切除术(MST组)36例,比较两组的临床结果。结果两组均无围术期死亡;两组围术期并发症、住院时间的差异均无显著性(P值均>0．05)。MST组手术时间(90 min)明显短于VAMT组(150 min,P<0．01)。结论VAMT和MST下行肺叶切除术均安全、可行,但前者适合于较早期的肺癌患者,后者几乎可应用于所有有手术指征的肺癌患者。

Inferior oblique weakening surgery on ocular torsion in congenital superior oblique palsy

AIM: To investigate changes in fundus excyclotorsion after inferior oblique myectomy or myotomy. METHODS: The records of 21 patients undergoing strabismus surgery by a single surgeon between 2009 and 2012 were examined. Only patients who had undergone an inferior oblique myectomy or myotomy,with or without horizontal rectus muscle surgery, were evaluated. Digital fundus photographs were obtained,and the angle formed by a horizontal line passing through the optic disc center and a reference line connecting the foveola and optic disc center was measured. Associated clinical factors examined include age at the time of surgery, presence or absence of a head tilt, degree of preoperative vertical deviation,torsional angle, inferior oblique muscle overaction/superior oblique muscle underaction, and surgery laterality. Whether the procedure was performed alone or in combination with a horizontal rectus muscle surgery was also examined. RESULTS: Mean preoperative torsional angle was12. 0 ± 6. 4 °, which decreased to 6. 9 ± 5. 7 ° after surgery(P 【0.001, paired t-test). Torsional angle also decreased from 15. 1 ± 7. 0 ° to 6. 2 ± 4. 3 ° in the myectomy group(P 【0.001, paired t-test) but there were no significant changes in the myotomy group(P =0.093, Wilcoxon signed rank test). Multivariable linear regression analysis showed that preoperative torsional angle, degree ofinferior oblique overaction, and age at surgery independently and significantly affected postoperative torsional angle.CONCLUSION: Mean torsional angle decreased after inferior oblique myectomy. Degree of preoperative torsional angle, inferior oblique overaction, and age at surgery influence postoperative torsional angle.

Improvements to the retractor and muscle flap design for minimally invasive cochlear implantation

Objective: The aim of this study was to improve muscle flaps and to evaluate surgical outcomes with the use of a novel specialized retractor, which is a surgical instrument used to locate and shape a bony seat for minimally invasive cochlear implantation.Methods: 50 patients aged 1 e75 years with sensorineural hearing loss who required cochlear implantation were recruited. A small incision(<3 cm) was made, and the novel specialized retractor was used in the study group during cochlear implantation. The incision length, surgical outcomes and operative time were recorded and analyzed.Results: The incision length, total operative time and drilling bony time were shorter in the study group than in the control group(P < 0.05, respectively). All patients recovered well after the surgery without any severe complications.Conclusion: The use of a novel specialized retractor standardized the surgical processes of cochlear implantation. The retractor helped locate and control the size of the bony well during bone drilling. The tool reduced the technical difficulty and improved the efficacy of this minimally invasive operation.

Relation between skeletal muscle volume and prognosis in rectal cancer patients undergoing neoadjuvant therapy

The prognostic role of body composition indexes,and specifically sarcopenia,has recently been explored in different cancer types.However,conflicting results have been reported.Heterogeneity in cancer type,cancer stage or oncological treatments,as well as different methodology and definition of sarcopenia,could be accounted for different conclusions retrieved from literature.When focusing on colorectal cancer,it clearly appears that colon and rectal cancers are often treated as a single entity though they have different behaviors and treatments.Particularly,patients with advanced rectal cancer represent a peculiar group of patients that according to current guidelines are treated with neoadjuvant chemotherapy and radiotherapy followed by radical surgery.This review was restricted to a homogeneous group of patients with advanced lower rectal cancer and the aim of exploring whether there is a correlation between skeletal muscle depletion and prognosis.Literature was searched for articles related to patients with advanced rectal cancer undergoing neoadjuvant chemo-radiotherapy(NCRT)followed by radical surgery,in whom muscle mass and/or change in muscle mass during neoadjuvant treatment were measured.Eight full-text articles were selected and included in the present review.The main findings of our review were:(1)The majority of the studies defined sarcopenia as muscle mass alone over muscle strength or physical performance;(2)There was a great deal of heterogeneity in the definition and measures of sarcopenia,in the definition of cut-off values,and in the method to measure change in muscle mass;(3)There was not full agreement on the association between sarcopenia at baseline and/or after chemoradiotherapy and prognosis,and only few studies found a significance in the multivariate analysis;and(4)It seems that a loss in skeletal muscle mass during NCRT is associated with the worst outcomes in terms of disease-free survival.In conclusion,analysis of muscle mass might provide prognostic information on patients with rectal cancer,however more robust evidence is needed to define the role of muscle depletion and/or muscle change during neoadjuvant treatments,related to this specific group of patients.If a prognostic role would be confirmed by future studies,the role of preoperative intervention aimed at modifying muscle mass could be explored in order to improve outcomes.

ACUPUNCTURE AT TRAGUS APEX FOR TREATMENT OF TRAUMATIC OCULAR MUSCLE PARALYSIS——A Report of 16 Cases

Traumatic ocular muscle paralysis is nota rare condition in clinical practice. However,complete recovery is very difficult. Withacupuncture at the tragus apex, we treated 16cases in the period of 1992-1996, withsatisfactory therapeutic results reported asfollows.

菱形肌联合前锯肌平面阻滞对肺叶切除患者镇痛效果的影响

目的探讨菱形肌联合前锯肌平面阻滞(RISS)对肺叶切除手术患者镇痛效果的影响。方法采用前瞻性研究方式,抽样选取2020年10月至2022年8月于我院行胸腔镜肺叶切除术治疗的82例患者作为研究对象,按照随机数字表法及双盲方式分为观察组(n=41)与对照组(n=41),观察组予以RISS阻滞联合静脉镇痛,对照组接受常规静脉镇痛,比较两组患者首次按压自控镇痛泵(PCIA)时间、48 h内PCIA有效按压次数、视觉模拟疼痛评分(VAS)、皮质醇(Cor)、去甲肾上腺素(NE)、CD3^(+)、CD4^(+)、CD8^(+)。结果观察组48 h内PCIA有效按压次数[(6.25±1.78)vs.(7.59±2.45)]次低于对照组,而首次按压PCIA时间[(12.85±2.85)h vs.(10.25±1.78 h)]长于对照组(t=2.274,、2.833、4.955,P<0.05)。重复测量方差分析显示,两组VAS评分、Cor、NE、CD3^(+)、CD4^(+)、CD8^(+)存在时间、组间及时间与组间交互作用,差异有统计学意义(P<0.05);在术后2、6、12、24、72 h时点,观察组的VAS评分均低于对照组(1.15±0.14)vs.(2.45±0.39)分、(2.05±0.31)vs.(3.42±0.59)分、(2.45±0.52)vs.(3.96±0.76)分、(2.11±0.35)vs.(3.02±0.57)分、(1.45±0.19)vs.(2.49±0.37)分(t=20.089、13.162、10.500、8.711、16.010,P<0.05);在术毕、术后24 h、72 h时点,观察组的Cor、NE均低于对照组(P<0.05)。在术后1、2 d,观察组的CD3^(+)、CD4^(+)高于对照组,而CD8^(+)低于对照组(P<0.05)。结论RISS用于胸腔镜肺叶切除术有利于增强镇痛效果,并减轻患者应激反应及减小对免疫功能的影响。

Evaluation of functional capacity, body composicion and pulmonary function after bariatric surgery

Introduction: Obesity has been considered a global epidemic and a serious public health problem closely related to other diseases. Moreover, obese individuals have limitations in physical capacity and pulmonary function. Weight loss induced by bariatric surgery appears to help reverse this situation. However, questions about physical capacity and lung function, and its relationship with body composition remain to be clarified. Objective: To evaluate the physical capacity, body composition and lung function in women undergoing bariatric surgery. Methods: Twenty five women who underwent bariatric surgery between 6 and 24 months ago, and 10 non-obese women were evaluated for exercise capacity by the six minutes walk test (6 MWT), body composition by bio-electrical impedance analysis and lung function by spirometry and measurement of maximal static respiratory pressures. Results: Subjects with BMI 2 were found to have better physical performance, demonstrated by increased 6 MWT distance, not differing from non-obese women. When compared with non-obese women, there were no significant differences in body composition and lung function. Higher BMI was correlated with shorter distances in 6 MWT. Conclusion: 6 to 24 months after surgery, when the weight loss of patients who underwent bariatric surgery reaches levels considered non-obese, it provides improvement in physical performance to a level similar to that of non-obese patients.

脑电双频指数监测下腋路臂丛神经阻滞复合全身麻醉在肩关节镜手术中的应用效果

目的:探究脑电双频指数(BIS)监测下腋路臂丛神经阻滞复合全身麻醉在肩关节镜手术中的应用效果。方法:选择2020年1月—2023年1月在宁夏医科大学总医院、吴忠市人民医院进行肩关节镜手术的患者86例,应用随机数字表法将其分为对照组(采用BIS监测下锁骨上入路臂丛神经阻滞复合全身麻醉)及观察组(采用BIS监测下腋路臂丛神经阻滞复合全身麻醉),各43例。对比两组不同时刻[麻醉前(T_(0))、气管插管即刻(T_(1))、切皮时(T_(2))、拔管时(T_(3))]心率(HR)、平均动脉压(MAP)、BIS值;对比两组麻醉苏醒后及术后2、12 h疼痛评分[视觉模拟评分法(VAS)]、肌力评分;对比两组术中舒芬太尼用量;对比两组不良反应发生率。结果:T_(0)时,两组HR、MAP比较,差异均无统计学意义(P>0.05);T_(1)、T_(2)、T_(3)时,观察组HR、MAP均低于对照组,差异均有统计学意义(P<0.05);T_(0)、T_(1)、T_(2)时,两组BIS比较,差异均无统计学意义(P>0.05);观察组T_(3)时BIS高于对照组,差异有统计学意义(P<0.05)。观察组麻醉苏醒后及术后6、12 h的VAS评分均低于对照组,肌力评分均高于对照组,差异均有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计意义(P>0.05)。结论:BIS监测下腋路臂丛神经阻滞复合全身麻醉在肩关节镜手术中的麻醉效果显著,可稳定血流动力学,患者术后疼痛程度较轻,对肌力影响较小,安全性较高。

无肌松药条件下气管插管后即刻监测运动诱发电位基线在腰椎手术中的应用

目的探讨腰椎手术在无肌松药气管插管后即刻监测运动诱发电位(TceMEP)基线的可行性。方法将2023年5-12月在徐州市中心医院拟行经椎间孔入路腰椎椎体间融合术(TLIF)的患者156例随机分为两组,最终对照组72例,男33例,女39例,观察组75例,男37例,女38例,对照组在术中脊柱暴露完成后监测TceMEP基线,观察组在无肌松药气管插管后即刻监测TceMEP基线。对比两组患者气管插管前后血流动力学变化、插管满意度和操作时间,并比较两组TceMEP基线引出成功率、刺激阈值、敏感性和特异性。结果两组患者气管插管时血流动力学变化与插管满意度差异无统计学意义(P>0.05),插管时间对照组为(6.52±1.22)min,观察组为(9.44±0.84)min,两组差异有统计学意义(P<0.05)。观察组TceMEP基线引出成功率为100%,平均刺激阈值(225.00±22.13)V,对照组TceMEP基线引出成功率为84.72%,平均刺激阈值(342.01±31.07)V,两组差异有统计学意义(P<0.05)。对照组在上钉后监测TceMEP成功率为93.06%,观察组为100%,两组差异有统计学意义(P<0.05)。两组TceMEP的敏感度和特异度差异无统计学意义(P>0.05)。结论无肌松气管插管后即刻监测TceMEP基线成功率高,刺激阈值小,敏感性与特异性与术中脊柱暴露完成后监测TceMEP基线无差别。

超声引导下双侧腰方肌阻滞、腹横肌平面阻滞对妇科腔镜手术患者术后镇痛效果比较

目的比较超声引导下双侧腰方肌阻滞(QLB)、腹横肌平面阻滞(TAPB)对妇科腔镜手术患者的术后镇痛效果。方法选取2022年1月至2023年12月周口市中心医院收治的74例拟行妇科腔镜手术患者作为研究对象,按随机抽签法分为TAPB组和QLB组各37例。QLB组患者采用超声引导下双侧QLB复合全麻,TAPB组采用超声引导下TAPB复合全麻。比较两组患者术前和术后3 h、12 h、24 h的应激反应指标[皮质醇、肾上腺素(EP)、去甲肾上腺素(NE)]和术后3 h、6 h、24 h、48 h疼痛视觉模拟法(VAS)评分,同时比较两组患者的镇痛泵使用情况及术后不良反应发生率。结果术后3 h、12 h及24 h,QLB组患者的EP水平分别为(102.73±19.82)μg/L、(117.82±20.35)μg/L、(92.74±17.12)μg/L,皮质醇水平分别为(254.37±26.31)μg/L、(292.84±27.59)μg/L、(247.42±30.25)μg/L、NE水平分别为(402.36±29.83)μg/L、(468.94±30.12)μg/L、(379.25±30.41)μg/L,明显低于TAPB组同时间点EP[(127.66±20.45)μg/L、(143.82±24.94)μg/L、(103.25±15.69)μg/L]、皮质醇[(289.63±26.94)μg/L、(318.62±32.45)μg/L、(264.83±28.49)μg/L]、NE[(498.25±32.45)μg/L、(576.88±25.64)μg/L、(402.37±32.11)μg/L],差异均有统计学意义(P<0.05);QLB组患者术后6 h、12 h、24 h的疼痛VAS评分分别为(3.20±0.63)分、(2.53±0.38)分、(1.82±0.39)分,明显低于TAPB组的(4.69±0.50)分、(3.52±0.40)分、(2.90±0.34)分,差异均有统计学意义(P<0.05);术后QLB组患者的镇痛泵首次使用时间为(11.54±2.13)h,明显长于TAPB组的(7.38±1.68)h,按压次数、舒芬太尼总用量分别为(5.14±1.36)次、(105.43±7.42)μg,明显少于TAPB组的(7.89±1.67)次、(121.23±9.54)μg,差异均有统计学意义(P<0.05);QLB组患者的不良反应总发生率为5.41%,明显低于TAPB组的21.62%,差异有统计学意义(P<0.05)。结论超声引导下双侧QLB用于妇科腔镜手术中可减轻患者术后应激反应和疼痛程度,减少镇痛泵中阿片类药物用量,减少麻醉药物相关不良反应的发生,安全性高。