Objective To compare the effect of ultrasound-guided sacral canal block and lumbar anesthesia on insulin resistance,proinflammatory cytokines,intraoperative safety and postoperative comfort in patients undergoing perianal infection surgery,and optimize the anesthesia strategy for patients undergoing perianal surgery.Methods A total of 120 patients with perianal infection treated in Shenzhen TCM Anorectal Hospital from December 2022 to June 2023 were selected as the study objects.They were divided into Sa group(60 cases)and Su group(60 cases)according to random number table method.Patients in Sa group underwent ultrasound-guided sacral canal block,and patients in Su group underwent subarachnoid space block.The levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),fasting plasma glucose(FPG),fasting insulin(FINS)and homeostasis model assessment of insulin resistance(HOMA-IR)in,and the incidence of intraoperative adverse events,postoperative pain score,postoperative nausea and vomiting score,and postoperative urinary retention rate of patients in the two groups were compared at the time of entry(T0),at the end of surgery(T1),7 h after surgery(T2),16 h after surgery(T3),and 40 h after surgery(T4).Results ln(HOMA-IR)at T3 in Sa group was lower than that in Su group,with statistical significance(P＜0.05).The TNF-α at T3 in Sa group was higher than that in Su group,and the difference was statistically significant(P＜0.05).The dynamic visual analogue scale(VAS)score at T4 in Sa group was lower than that in Su group,and the difference was statistically significant(P＜0.05).FPG at T3 and T4 in Sa group was lower than that at T0 time point in this group,and the difference was statistically significant(P＜0.05).FINS and ln(HOMA-IR)at T3 and T4 in Sa group were lower than those at T0,and the differences were statistically significant(P＜0.05).ln(HOMA-IR)at T3 and T4 in Su group was lower than that at T0 in this group,and the difference was statistically significant(P＜0.05).There were no significant differences in the incidence of adverse events,postoperative nausea and vomiting score and postoperative urinary retention between the two groups(P＞0.05).Conclusion The effect of ultrasound-guided sacral canal block on reducing insulin resistance in patients with perianal infection was better than that of lumbar anesthesia,and the analgesic effect was more lasting.
关键词
超声引导/骶管阻滞/蛛网膜下隙阻滞/肛周感染/胰岛素抵抗
Key words
Ultrasound-guided/Sacral canal block/Sub-arachnoid space block/Perianal infection/Insulin resistance
维普
万方数据