中国现代医学杂志2023，Vol.33Issue(24)：94-100,7.DOI:10.3969/j.issn.1005-8982.2023.24.016
超声引导下腰方肌阻滞用于腹腔镜结直肠手术围手术期的麻醉效果及对术后睡眠质量的影响
Perioperative anesthetic effect of ultrasound-guided quadratus lumborum block and its impact on postoperative sleep quality in patients undergoing laparoscopic colorectal surgery
摘要
Abstract
Objective To explore the anesthetic effect of ultrasound-guided quadratus lumborum block(QLB)during the perioperative period of laparoscopic colorectal surgery and its impact on postoperative sleep quality.Methods Eighty patients who underwent laparoscopic colorectal surgery in Huai'an 82nd Hospital from January 2019 to January 2022 were selected and divided into an observation group and a control group by a random draw,with 40 patients in each group.Under ultrasound guidance,the control group underwent transversus abdominis plane block(TAPB),while the observation group underwent bilateral QLB.Perioperative indicators,heart rate(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP),sleep quality assessed via the subjective sleep quality score,total consumption of analgesics via the pump system within 24 hours,the Visual Analogue Scale(VAS)score,immune function(frequency of CD3+,CD4+,CD8+,and CD4+/CD8+cells),adverse reactions,and postoperative use of painkillers were compared between the two groups.Results The dosage of remifentanil was lower,and the time to first flatus and defecation was shorter in the observation group compared with those in the control group(P＜0.05).The SBP,DBP,and HR at T0,T1,T2,and T3 were compared between the observation group and the control group.The results showed that there were statistically significant differences in SBP,DBP,and HR among different time points(F=22.396,15.403,and 7.676,all P=0.000)and between the observation group and the control group(F=44.528,21.176,and 21.683,all P=0.000),and that the change trends of SBP,DBP,and HR were different between the observation group and the control group(F=38.764,19.075,and 12.840,all P=0.000).The subjective sleep quality score of the observation group was higher than that of the control group(P＜0.05).The total consumption of analgesics via the pump system within 24 hours in the observation group was lower than that in the control group(P＜0.05).Comparison of VAS scores measured at rest and during activity between the observation group and the control group at 1 hour,6 hours,12 hours,and 24 hours after surgery revealed that there were differences in VAS scores measured at rest and during activity among different time points(F=14.635 and 20.754,both P=0.000)and between the observation group and the control group(F=48.432 and 51.267,both P=0.000),and that the change trends of VAS scores measured at rest and during activity were also different between the observation group and the control group(F=18.416 and 22.763,both P=0.000).The decreases in frequency of CD3+,CD4+,CD8+,and CD4+/CD8+cells after surgery in the observation group were lower than those in the control group(P＜0.05).The incidence of adverse reactions and the rate of postoperative use of painkillers in the observation group were lower than those in the control group(P＜0.05).Conclusions Ultrasound-guided QLB effectively alleviates postoperative pain and improves postoperative sleep quality in patients undergoing laparoscopic colorectal surgery with a high safety profile.关键词
腰方肌阻滞/超声引导/腹腔镜/结直肠/睡眠质量/疼痛Key words
quadratus lumborum block/ultrasound guidance/laparoscopy/colorectal/sleep quality/pain分类
医药卫生引用本文复制引用
王玉秀,沈露露,胡丹丹..超声引导下腰方肌阻滞用于腹腔镜结直肠手术围手术期的麻醉效果及对术后睡眠质量的影响[J].中国现代医学杂志,2023,33(24):94-100,7.基金项目
江苏省自然科学基金(No:BK20201084) （No:BK20201084）
