超声引导下双侧腹横肌平面阻滞复合全身麻醉在结直肠癌根治术中的应用

刘海盛 唐丽双

[摘要]目的 探討超声引导下双侧腹横肌平面阻滞复合全身麻醉在结直肠癌根治术中的应用效果。方法 选择我院2015年1月～2016年7月收治的70例结直肠癌根治术患者作为研究对象，按照随机数字表法分为观察组与对照组，每组各35例。对照组选择全身麻醉，观察组选择超声引导下双侧腹横肌平面阻滞+全身麻醉，比较两组的麻醉效果、术中全身麻醉药物用量、生命体征指标、术后意识恢复时间。结果 两组的麻醉优良率比较，差异无统计学意义（P>0.05）。观察组术中丙泊酚用量、舒芬太尼用量均少于对照组，差异均有统计学意义（P<0.05）。两组的麻醉持续时间比较，差异无统计学意义（P>0.05）。两组麻醉前后的心率、平均动脉压比较，差异均无统计学意义（P>0.05）。观察组的术后睁眼、吞咽反射恢复、定向力恢复时间均短于对照组，差异有统计学意义（P<0.05）。结论 超声引导下双侧腹横肌平面阻滞复合全身麻醉可在确保结直肠癌根治术患者麻醉效果及麻醉持续时间的前提下，减少全身麻醉药物用量，加快术后意识恢复。

[关键词]结直肠癌根治术;全身麻醉;超声引导;腹横肌平面阻滞

[中图分类号] R614.2          [文献标识码] A          [文章编号] 1674-4721（2020）7（b）-0142-04

Application of ultrasound-guided bilateral transverse abdominal muscle block combined with general anesthesia in radical resection of colorectal cancer

LIU Hai-sheng   TANG Li-shuang

Department of Anesthesiology， Zengcheng District People′s Hospital of Guangzhou City， Guangdong Province， Guangzhou   511300， China

[Abstract] Objective To investigate the application effect of ultrasound-guided bilateral transverse abdominal muscle block combined with general anesthesia in radical resection of colorectal cancer. Methods A total of 70 cases of patients who underwent radical colorectal cancer treatment from January 2015 to July 2016 in our hospital were selected as the research subjects. According to the random number table method， they were divided into the observation group and the control group， 35 cases in the each group. The control group was selected under general anesthesia， the observation group was selected ultrasound-guided bilateral transverse abdominal muscle block combined with general anesthesia. The effects of anesthesia， the amount of general anesthetic drugs during the operation， vital signs indicators and the recovery time of postoperative consciousness were compared between the two groups. Results There was no significant difference in the excellent and good rate of anesthesia between the two groups （P>0.05）. The dosage of Propofol and Sufentanil in the observation group were lower than those in the control group， and the differences were statistically significant （P<0.05）. There was no significant difference in the duration of anesthesia between the two groups （P>0.05）. There were no significant differences in the heart rate and mean arterial pressure of the two groups between before and after anesthesia （P>0.05）. The recovery time of eyes opening， swallowing reflex and orientation force in the observation group were shorter than those in the control group， and the differences were statistically significant （P<0.05）. Conclusion Ultrasound-guided bilateral transverse abdominal muscle block combined with general anesthesia can reduce the dosage of general anesthesia drugs and accelerate the recovery of postoperative consciousness on the premise of ensuring the anesthesia effect and duration of colorectal cancer radical operation.

[Key words] Radical colorectal cancer surgery; General anesthesia; Ultrasound guidance; Transverse abdominal muscle block

结直肠癌属于消化系统常见恶性肿瘤，具有高发病率、高死亡率的特点，严重危害了广大居民的生命健康[1]。结直肠癌的治疗方法以结直肠癌根治术为主[2]，而这类手术的麻醉方式以气管插管全身麻醉为主。气管插管全身麻醉可在结直肠癌根治术中起到良好的麻醉作用，但部分患者在手术后存在苏醒延迟问题，认知功能受到影响，不利于预后[3-4]。超声引导下腹横肌平面阻滞是一种神经阻滞麻醉方法，有研究报道指出，超声引导下腹横肌平面阻滞复合全身麻醉可加快全身麻醉手术后患者苏醒，具有一定的应用效果[5]。本研究旨……