Application effect of QLB and TAPB under ultrasound-guided general anesthesia in patients undergoing cardiac cancer surgery
Objective To explore the analgesic effect of general anesthesia ultrasound-guided quadratus lumborum block(QLB)and the inferior transverse abdominis plane block(TAPB)in patients undergoing abdominal cardia cancer surgery and its effect on inflammatory factors and stress response.Methods From February 2022 to December 2022,totally 80 pa-tients underwent radical abdominal cardia cancer under general anesthesia in the Anyang Cancer Hospital,which were di-vided into control group(40 cases)and test group(40 cases)by random number table.Before the induction of general anesthesia,the control group received ultrasound-guided bilateral subcostal TAPB,and the test group received QLB bi-lateral through the lateral arcuate ligament.In both groups,0.333％ropivacaine 30 mL was administered on each side.The surgery and anesthesia were performed by the team led by the same senior physician.The numerical rating scale(NRS)scores at 2 hours,8 hours,12 hours and 24 hours after operation were compared between the two groups,and the inflammatory factors such as tumor necrosis factor-α(TNF-α)before anesthesia(t0),before skin incision after anes-thesia induction(t1)and 24 hours after operation(T2)were compared.TNF-α),interleukin-10(IL-10),stress re-sponse indexes such as heart rate(HR)and systolic blood pressure(SBP),as well as clinical therapeutic effect,ICU treatment time,hospitalization time and complications.Results The NRS scores of the experimental group were signifi-cantly lower than those of the control group at2h,8h,12h,and 24 h after surgery(P＜0.05).At time points T1 and T2,two sets of TNF-α、IL-10 increased at all time points compared to T0(P＜0.05),but the experimental group was significantly lower than that in the control group(P＜0.05).At time points T1 and T2,HR and SBP in the control group increased compared to T0(P＜0.05),and the experimental group was significantly lower than that in the control group(P＜0.05).The clinical treatment efficacy of the experimental group was better than that of the control group(P＜0.05),and the total clinical treatment effective rate of the experimental group was 97.50％,significantly higher than the 80.00％of the control group(P＜0.05).The ICU treatment time and postoperative hospitalization time in the experi-mental group were significantly shorter than those in the control group(P＜0.05).The incidence of complications in the experimental group was 5.00％,significantly lower than the 22.50％in the control group(P＜0.05).Conclusion Com-pared with TAPB under ultrasound guidance of general anesthesia,QLB in patients with radical abdominal cardiac cancer can effectively improve analgesic effect,reduce inflammation and stress response,improve clinical treatment efficacy,shorten ICU treatment time and hospitalization time,and reduce complications.It has obvious advantages in clinical appli-cation,which is worth popularizing.
General anesthesiaQuadratus lumborum blockUltrasound-guidedTransverse abdominis plane blockCardiac cancerSurgeryAnalgesic effectInflammatory factors
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