Application of Ultrasound-guided Anterior Quadratus Lumborum Block at the Lateral Supra-arcuate Ligament Combined with Total Intravenous Anesthesia in Patients Undergoing Laparoscopic Surgery for Rectal Cancer
Objective:To explore the application value of ultrasound-guided anterior quadratus lumborum block at the lateral supra-arcuate ligament(QLB-LSAL)combined with total intravenous anesthesia in laparoscopic surgery for rectal cancer patients.Method:50 patients with rectal cancer who underwent laparoscopic surgery under total intravenous anesthesia in Gaozhou People's Hospital from January 2022 to January 2024,were selected as the study objects and included in the control group.50 patients with rectal cancer who underwent laparoscopic surgery under ultrasound-guided QLB-LSAL combined with total intravenous anesthesia in the hospital during the same period were selected as the study objects and included in the observation group.Patient medical records,surgical datas and other related materials were all kept intact.The patients'datas were collected,and the hemodynamics[mean arterial pressure(MAP)and heart rate(HR)],intraoperative anesthetic dosage,postoperative recovery,postoperative pain degree[numerical rating scale(NRS)results at rest and during activity 24 h after operation]and adverse reactions were recorded and compared at the time of entering the room,skin incision and 30 min after suture.Result:The MAP and HR of both groups of patients decreased during skin cutting compared to entering the room,and rebounded 30 minutes after suturing,but were still lower than those entering the room,with statistical significant differences(P<0.05).The MAP and HR of the observation group were higher than those of the control group during skin cutting and 30 minutes after suturing,with statistical significant differences(P<0.05).The dosage of remifentanil in the observation group was less than that in the control group,and the number of analgesic pump presses was less than that in the control group 48 hours after surgery,and first time to exhaust and the time to get out of bed were shorter than those in the control group,with statistical differences(P<0.05).The NRS scores of the observation group at rest and during activity were lower than those of the control group,and the incidence of drug-related adverse reactions was lower than that of the control group,with statistical significant differences(P<0.05).Conclusion:The application of QLB-LSAL combined with total intravenous anesthesia under ultrasound guidance in laparoscopic surgery for rectal cancer can help stabilize patient hemodynamics,provide ideal postoperative pain relief,facilitate postoperative functional recovery,reduce the dosage of remifentanil,reduce drug related adverse reactions,and improve overall surgical safety.
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