Application Bilateral Posterior Sheath of Rectus Abdominalis and Transverse Abdominalis Plane Block Under General Anesthesia Combined with Ultrasound-guided Anesthesia in Patients with Ultra-low Rectal Cancer
Objective:To investigate the efficacy and safety of bilateral posterior sheath of rectus abdominis,and transverse abdominis plane block under general anesthesia combined with ultrasound-guided anesthesia in patients with ultra-low rectal cancer.Methods:64 patients with ultra-low rectal cancer who were scheduled to receive open colorectal resection in the hospital from January 2021 to January 2023 were selected as research objects,and were divided into observation group and control group according to random number table method,with 32 cases in each group.The control group received conventional anesthesia,and the observation group received general anesthesia plus ultrasound-guided combined anesthesia program of bilateral posterior sheath of rectus abdominis and transversal abdominis plane block.Perioperative indexes(number of analgesic pump compressions,recovery time of anal exhaust,and first time of getting out of bed)were compared between the two groups.4 h(T1),8 h(T2),16 h(T3)and 24 h(T4)were taken as time nodes to compare the visual analog scale(VAS)of pain at resting state and exercise state between the two groups.The consumption of sufentanil was compared between the two groups at different time periods(0～12 h,12～24 h,24～36 h,36～48 h).Before anesthesia(t0),2 h after surgery(t1),24 h after surgery(t2)as time nodes,the immune function indexes(CD3+,CD4+,CD8+)and the occurrence of adverse reactions between the two groups were compared.Results:The number of analgesic pump compressions in observation group was less than that in control group,and the recovery time of anal exhaust and the first time of getting out of bed in observation group were shorter than those in control group,with statistically significant difference(t=-7.119,-3.277,-14.938;P＜0.05).From T1 to T3,VAS scores in resting state and exercise state in observation group were lower than those in control group,with statistically significant differences(t=-17.183,-10.620,-14.045,-22.556,-16.659,-24.800;P＜0.05).0～12 h,12～24 h after operation the consumption and total consumption of sufentanil in observation group were lower than those in control group,and the differences were statistically significant(t=-33.316,-25.440,-40.104;P＜0.05).At t2 time,the levels of CD3+and CD4+in observation group were higher than those in control group,and the levels of CD8+in observation group were lower than those in control group,with statistically significant difference(t=3.999,4.128,2.050;P＜0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(x2=0.474,P＞0.05).Conclusion:General anesthesia combined with ultrasound-guided bilateral posterior sheath of rectus abdominis,and plane block of transversal abdominis can effectively improve analgesic quality;reduce the amount of narcotic drugs;promote anal exhaust,early ambulation;accelerate the recovery of immune function;and guarantee the safety of anesthesia in patients with ultra low rectal cancer.
General anesthesiaPosterior sheath block of rectusTransversal plane blockUltralow rectal cancer
万方数据
维普
