【摘要】 目的探讨超声引导下腹横肌平面阻滞联合腹直肌鞘阻滞在结直肠癌根治术围术期镇痛中的应用效果。方法选择接受结直肠癌根治术治疗的120例患者,利用随机数字表法将患者分为对照组(60例)和观察组(60例),其中对照组患者在超声引导下行腹横肌平面阻滞,观察组患者在超声引导下行腹横肌平面阻滞联合腹直肌鞘阻滞。对比两组患者各时点心率、平均动脉压、VAS评分,以及并发症发生率。结果麻醉诱导前(T0)、手术开始时(T1)及手术开始后1 h(T2),两组患者心率、平均动脉压水平差异无统计学意义(均P>0.05)。观察组拔管后15 min(T3)的心率、平均动脉压水平,以及出麻醉恢复室时、术后4 h、术后12 h、术后24 h的VAS评分均低于对照组(均P<0.05)。观察组头晕、嗜睡以及恶心呕吐发生率均低于对照组(均P<0.05)。结论在超声引导下进行腹横肌平面阻滞联合腹直肌鞘阻滞可维持结直肠癌根治术患者的术后心率以及平均动脉压平稳,缓解术后疼痛感,还可降低并发症发生率,临床效果显著。更多还原

【Abstract】 Objective To explore the application effects of ultrasound-guided transversus abdominis plane block combined with rectus sheath block in perioperative analgesia during radical resection of colorectal cancer. Methods A total of 120 patients received radical resection of colorectal cancer for treatment were selected, and they were assigned to control group(60 cases) and observation group(60 cases) according to the random number table method, among which patients in the control group were conducted with ultrasound-guided transversus abdominis plane block, whereas the observation group was conducted with ultrasound-guided transversus abdominis plane block combined with rectus sheath block. The heart rate, mean arterial pressure, and the VAS scores in various time points, as well as the incidence of complications were compared between the two groups. Results There were no statistically significant differences in the heart rate, mean arterial pressure before anesthesia induction(T0), at the beginning of operation(T1), and 1 h after operation(T2) between the two groups(all P>0.05). The observation group yielded lower levels of heart rate and mean arterial pressure 15 min after extubation(T3), and lower VAS scores at the time of leaving anesthesia recovery room, and 4 h, 12 h, 24 h after operation as compared with the control group(all P<0.05). Compared to the control group, the observation group yielded a lower incidence of dizziness, drowsiness, and nausea and vomiting(all P<0.05). Conclusion Ultrasound-guided transversus abdominis plane block combined with rectus sheath block can maintain the postoperative heart rate and mean arterial pressure stable in patients with colorectal cancer after raclical resection, relieve postoperative pain, and also decrease the incidence of complications, with a significant clinical effect.更多还原