中国现代医学杂志2023，Vol.33Issue(23)：85-91,7.DOI:10.3969/j.issn.1005-8982.2023.23.015
超声引导下腰方肌外侧路阻滞联合少阿片类药物麻醉对老年腹腔镜肾癌根治术患者的影响
Effect of quadratus lumborum block combined with less opioid anesthesia under ultrasound guidance on elderly patients with laparoscopic radical nephrectomy
摘要
Abstract
Objective To analyze the impact of ultrasound-guided lumbar plexus lateral block combined with minimal opioid anesthesia on neuroinjury factors,pain levels,and mental status in elderly patients undergoing laparoscopic radical nephrectomy for renal cancer.Methods Sixty elderly patients undergoing laparoscopic radical nephrectomy from August 2021 to August 2022 at the First Affiliated Hospital of North University of China were selected.They were randomly divided into a control group and a study group,with 30 patients in each group.All patients received ultrasound-guided lumbar plexus lateral block.The control group received combined traditional opioid anesthesia,while the study group received combined minimal opioid anesthesia.Static and dynamic Visual Analog Scale(VAS)scores,patient-controlled analgesia(PCA)pump presses,and postoperative recovery indicators were recorded.The Mini-Mental State Examination(MMSE)and the levels of neuroinjury factors serotonin(5-HT),brain-derived neurotrophic factor(BDNF),and neuron-specific enolase(NSE)were compared at different time points[anesthesia induction(T0),postoperative day 1(T1),postoperative day 3(T2),and postoperative day 7(T3)].Results The study group had significantly shorter first-time gas evacuation,first-time defecation,and time to get out of bed compared to the control group(P＜0.05).The number of PCA pump presses was lower in the study group than in the control group(P＜0.05).There was no significant difference in resting VAS scores and activity VAS scores between the two groups at 12,24,and 48 hours postoperatively(P＞0.05).MMSE scores and BDNF levels in the study group at T1,T2,and T3 were higher than those in the control group,while serum 5-HT and NSE levels were lower than those in the control group(P＜0.05).The incidence of anesthesia-related adverse reactions in the study group was lower than that in the control group(P＜0.05).Conclusion:Ultrasound-guided lumbar plexus lateral block combined with minimal opioid anesthesia in elderly patients undergoing laparoscopic radical nephrectomy for renal cancer can alleviate perioperative pain,shorten postoperative recovery time,and improve cognitive function and the expression of neuroinjury factors.关键词
肾癌/超声引导下腰方肌外侧路阻滞/腹腔镜肾癌根治术/阿片类药物/神经损伤因子Key words
renal cancer/ultrasound-guided lumbar plexus lateral block/laparoscopic radical nephrectomy/opioid drugs/neuroinjury factors分类
医药卫生引用本文复制引用
孙晓佳,汪业铭,孟晨雪,刘禹濛,赵立春,赵继波..超声引导下腰方肌外侧路阻滞联合少阿片类药物麻醉对老年腹腔镜肾癌根治术患者的影响[J].中国现代医学杂志,2023,33(23):85-91,7.基金项目
2023年度河北省医学科学研究课题计划项目(No:20231454) （No:20231454）
张家口市2022年市级科技计划自筹经费项目(No:2221142D) （No:2221142D）
