实用医学杂志2025，Vol.41Issue(19)：2979-2984,6.DOI:10.3969/j.issn.1006-5725.2025.19.004
腰方肌阻滞复合依托咪酯麻醉对老年结直肠癌手术患者苏醒质量和肠道屏障功能的影响
The effect of Quadratus lumborum block combined with etomidate anesthesia on the quality of recovery and intestinal barrier function in elderly patients undergoing colorectal cancer surgery
摘要
Abstract
Objective To evaluate the effect of quadratus lumborum block combined with etomidate anes-thesia on recovery quality and intestinal barrier function in elderly patients undergoing colorectal cancer surgery.Methods One hundred and twenty-six consecutive elderly patients with colorectal cancer who were admitted to The First People's Hospital of Changzhou from January 2023 to February 2025 were randomly divided into a control group and an observation group using an odd-even numbering method,with 63 cases in each group.The control group received general intravenous anesthesia during surgery,while the observation group received quadratus lumborum block on lateral arcuate ligament before general anesthesia.Heart rate and mean arterial pressure fluctua-tions were recorded pre-operatively(T0),at skin incision(T1),15 minutes after the start of operation(T2),at lesion resection(T3),5 minutes before the end of operation(T4).Intraoperative surgical indicators and postoperative recovery profile were documented as well.The two groups were compared in terms of postoperative pain,stress indi-cators,intestinal barrier indicators,and safety.Results Repeated-measures analysis of variance showed no statis-tically significant difference in heart rate and mean arterial pressure between the two groups at T0,T1,T2,T3,and T4(all P>0.05),but statistically significant differences in the two indicators within respective group at all the same time points(all P<0.05).Both groups showed statistically significant differences in variances at all the time points(P<0.05).The two groups had statistically significant differences in postoperative recovery time(40.02±16.31 min vs.48.61±15.09 min;P<0.05)and tracheal tube removal time(8.03±1.92 min vs.9.15±1.23 min;P<0.05).Pain scores at 2 hours,24 hours,72 hours,and 1 week postoperatively were shorter in the observation group(P<0.05),with a parallel decrease over time in both groups(all P<0.05).Effective presses of the self-controlled analgesia pump within 48 hours postoperatively was significantly fewer in the observation group(P<0.05).Although the postoperative levels of norepinephrine,adrenaline,cortisol,D-lactate,and diamine oxidase increased in both groups,he observation group had significantly lower levels compared with the control group(P<0.05).No serious complications or adverse reactions were observed in either group.Conclusion The regimen of quadratus lumborum block combined with etomidate anesthesia in laparoscopic radical surgery for elderly colorectal cancer patients shortens the patient's postoperative recovery time,reduces intestinal barrier damage,alleviates postoperative pain and stress response,promising a favorable safety profile.关键词
结直肠癌/腰方肌阻滞/依托咪酯/疼痛/肠道屏障Key words
colorectal cancer/quadratus lumborum block/etomidate/pain/intestinal barrier分类
医药卫生引用本文复制引用
胡婷婷,张菁..腰方肌阻滞复合依托咪酯麻醉对老年结直肠癌手术患者苏醒质量和肠道屏障功能的影响[J].实用医学杂志,2025,41(19):2979-2984,6.基金项目
江苏省自然科学基金项目(编号:BK20201084) （编号:BK20201084）
