Application of different plane block combined with general anesthesia under ultrasound guidance in patients undergoing laparoscopic radical gastrectomy for gastric cancer and its influence on hemodynamics
10.3760/cma.j.cn431274-20240305-00365
- VernacularTitle:超声引导下不同平面阻滞联合全麻在腹腔镜胃癌根治术患者中的应用及对血流动力学的影响
- Author:
Huajuan WANG
1
;
Rongen QIU
1
;
Ling XU
1
;
Shan LIU
1
;
Wangsheng WU
1
Author Information
1. 温州医科大学附属衢州医院(衢州市人民医院)麻醉科，衢州 324000
- Publication Type:Journal Article
- Keywords:
Stomach neoplasms;
Laparoscopy;
Nerve block;
Quadratus lumbar block;
Erector spinae plane block
- From:
Journal of Chinese Physician
2025;27(1):71-75
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the effect of different plane block under general anesthesia combined with ultrasound guidance in laparoscopic radical gastrectomy for gastric cancer.Methods:A total of 160 patients with gastric cancer admitted to the Quzhou Hospital Affiliated to Wenzhou Medical University from June 2022 to September 2023 were selected and divided into control group and observation group by random number table method, with 80 cases in each group. All participants underwent general anesthesia. On this basis, the control group combined with ultrasonic-guided vertical spinal plane block (ESPB). The observation group was combined with ultrasound-guided quadratus lumbar block (QLB). The hemodynamics, stress response, pain degree, postoperative recovery time, adverse events and quality of recovery from anesthesia were compared between the two groups.Results:The mean arterial pressure (MAP) level at the time of skin incision (T 1) and lesion resection (T 2) in observation group was lower than that in control group, and the heart rate (HR) at the time of T 1, T 2 and after surgery (T 3) was lower than that in control group (all P<0.05). The levels of cortisol (Cor) and interleukin-6 (IL-6) in the observation group were lower than those in control group after anesthesia induction, 10 min after skin resection, 24 h after surgery (all P<0.05). The scores of Visual Analogue Scale (VAS) at rest and exercise at 2, 6, 12, 24 and 48 h in the observation group were lower than those in the control group (all P<0.05). The time of awakening, getting out of bed and anal exhaust in the observation group was shorter than that in the control group (all P<0.05). There was no significant difference in the incidence of adverse events between the observation group and the control group [11.25%(9/80) vs 16.25%(13/80), P>0.05]. The scores and total scores of 40-item Quality of Recovery Score (QoR-40) in the observation group were higher than those in the control group (all P<0.05). Conclusions:Compared with ultrasound-guided ESPB combined with general anesthesia, the application of ultrasound-guided QLB combined with general anesthesia in laparoscopic radical gastrectomy for gastric cancer can achieve better perioperative analgesia effect, which is conducive to stabilizing the hemodynamics of patients and alleviating the stress response of the body, and the postoperative recovery time of patients is shorter, which can improve the quality of anesthesia recovery of patients.
