目的 观察颊针疗法对腹腔镜结肠癌根治术患者围术期镇痛效果的影响.方法 选择择期行腹腔镜结肠癌根治术的患者60例,男32例,女28例,年龄45～74岁,BMI 18.5～25.0 kg/m2,ASA Ⅱ或Ⅲ级.采用随机数字表法将患者分为两组:颊针组和对照组,每组30例.颊针组麻醉诱导前给予颊针疗法1次,术后每日上午9点行颊针疗法1次,每次留针30 min,连续治疗3 d;对照组不行颊针治疗.记录术中丙泊酚、瑞芬太尼、术后48 h内舒芬太尼用量和镇痛泵按压次数.记录术后1、4、24、48 h VAS疼痛评分.分别于入室时及术后1、2、3 d采集静脉血,检测血浆C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)的浓度.记录术后48 h内不良反应的发生情况.结果 与对照组比较,颊针组术中丙泊酚、瑞芬太尼、术后48 h内舒芬太尼用量及镇痛泵按压次数明显减少(P＜0.05),术后1、4、24、48 h VAS疼痛评分明显降低(P＜0.05),术后1、2、3 d CRP、IL-6、TNF-α浓度明显降低(P＜0.05),术后48 h内恶心呕吐、喉痉挛及咽喉不适发生率明显降低(P＜0.05).结论 对腹腔镜结肠癌根治术患者围术期运用颊针疗法,可以有效减轻疼痛,抑制炎症反应,减少术后不良反应.
Effect of buccal needle therapy on perioperative analgesic effects in patients undergoing laparoscopic radical colon cancer surgery
Objective To observe the effect of buccal needle therapy on perioperative analgesia in patients undergoing laparoscopic radical colon cancer surgery.Methods Sixty patients underwent dective laparoscopic radical of colon cancer surgery were selected,32 males and 28 females,aged 45-74 years,BMI 18.5-25.0 kg/m2 and ASA physical status Ⅱ or Ⅲ.The patients were divided into two groups using the randomized numerical table method:buccal needle group and control group,30 patients in each group.Before the induction of anesthesia,the buccal needle group was given buccal needle therapy once,and buc-cal needle therapy was performed once a day at 9 a.m.in the postoperative period,leaving the needle in place for 30 minutes each time,for 3 consecutive days of treatment,and the control group was not treated with buccal needle therapy.The amount of intraoperative propofol,remifentanil,sufentanil used in the 48 hours postoperative period and recorded.VAS pain scores were recorded at 1 hour,4,24,and 48 hours postoperatively.Venous blood was collected at the time of admission to the hand room and at 1 day,2,and 3 days postoperatively,respectively,and the concentrations of plasma C-reactive protein(CRP),interleu-kin-6(IL-6),and tumor necrosis factor-alpha(TNF-α)were measured.The occurrence of adverse reactions within 48 hours after operation was recorded.Results Compared with the control group,intraop-erative propofol,remifentanil,the amount of sufentanil used and the number of analgesic pump presses with-in 48 hours after operation in the buccal needle group were significantly reduced in the buccal needle group(P＜0.05),VAS pain scores were significantly lower at 1 hour,4,24,and 48 hours postoperatively(P＜0.05),CRP,IL-6,and TNF-α concentrations were significantly lower at 1 day,2,and 3 days postopera-tively(P＜0.05),and nausea and vomiting,incidence of laryngospasm and laryngeal discomfort were sig-nificantly reduced(P＜0.05).Conclusion The perioperative use of buccal needle therapy in patients un-dergoing laparoscopic radical colon cancer surgery can effectively reduce pain,inhibit inflammatory respon-ses,and decrease the incidence of postoperative adverse reactions.
Buccal needleRadical colon cancer surgeryPainAnalgesiaInflammatory factors
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