国际医药卫生导报2025，Vol.31Issue(10)：1604-1609,6.DOI:10.3760/cma.j.cn441417-20241021-10004
腰方肌区域神经阻滞联合全身麻醉在老年妇科腹腔镜手术患者中的应用
Quadratus lumborum block combined with general anesthesia for elderly patients undergoing gynecologic laparoscopic surgery
摘要
Abstract
Objective To explore the effect of quadratus lumborum block combined with general anesthesia for elderly patients undergoing gynecological laparoscopic surgery.Methods Ninety-six elderly patients who underwent gynecological laparoscopic surgery at Baoji Maternal and Child Health Hospital from January 2021 to January 2023 were selected for the randomized controlled trial,and were divided into a control group who were(70.86±7.63)years old and an observation group who were(71.14±7.87)years old by the random number table method,with 48 cases in each group.Both groups received general anesthesia during the surgery;the observation group took quadratus lumborum block 30 min before anesthesia induction.The perioperative parameters(remifentanil and propofol dosages,awakening time,and time to recovery of spontaneous breathing)were compared between the two groups.The heart rate and mean arterial pressure were recorded before induction(T0),5 min after intubation(T1),at skin incision(T2),and after the surgery(T3).The pain scores and comfort scores(BCS)1 and 24 h after the surgery and the stress indicators before and 24 h after the surgery were compared between the two groups.Before and 1,3,and 7 d after the surgery,their cognitive function was assessed using the Mini-Mental State Examination(MMSE).The incidence rates of cognitive impairment and adverse reactions were recorded.t test,repeated measurement analysis of variatment,and x2 were used for the statistical comparisons.Results The dosages of remifentanil and propofol,awakening time,and time to recovery of spontaneous breathing in the control group were(1.35±0.31)mg,(410.25±43.12)mg,(6.49±1.23)min,and(15.07±2.43)min,and those in the observation group(0.72±0.21)mg,(326.78±37.69)mg,(4.06±0.81)min,and(9.55±1.62)min;the intraoperative heart rate and mean arterial pressure in the observation group were more stable than those in the control group;there were statistical differences(all P＜0.05).There were statistical differences in the postoperative scores of pain and BCS between the observation group and the control group were(3.54±0.40 vs.4.13±0.43 and 2.78±0.40 vs.2.03±0.38),with statistical differences(all P＜0.05).The observation group had lower postoperative stress markers and a higher MMSE score than the control group,with statistical differences(all P＜0.05).The incidence rates of cognitive impairment and adverse reactions in the observation group were lower than those in the control group[2.08％(1/48)vs.14.58％(7/48)and 6.25％(3/48)vs.18.75％(9/48);both P＜0.05].Conclusion Quadratus lumborum block combined with general anesthesia can maintain hemodynamic stable in elderly patients undergoing gynecological laparoscopic surgery and reduce the risk of postoperative cognitive dysfunction and adverse reactions.关键词
全身麻醉/腰方肌区域神经阻滞/老年/妇科腹腔镜手术/认知功能障碍Key words
General anesthesia/Quadratus lumborum regional nerve block/Ederly patients/Gnecological laparoscopic surgery/Cognitive dysfunction引用本文复制引用
邓小英,梁皓,温柔,张永刚..腰方肌区域神经阻滞联合全身麻醉在老年妇科腹腔镜手术患者中的应用[J].国际医药卫生导报,2025,31(10):1604-1609,6.基金项目
陕西省重点研发计划(2022SF-585) Key Plan of Research and Development in Shaanxi(2022SF-585) （2022SF-585）
