| Objective:To observe the effects of ultrasound-guided quadratus lumborum block(QLB)and thoracic paravertebral block(TPVB)on postoperative analgesia of patients undergoing laparoscopic radical resection of colorectal cance.Methods:A total of 80 patients underwent elective laparoscopic radical resection of colorectal cancer under general anesthesia in the second affiliated Hospital of Nanchang University from July 2020 to December 2020,with age:40-80 years old,ASA II,body mass index(BMI):18-32kg/m~2.The subjects were randomly divided into two groups with 40 patients in each group(n=40):lumbar quadratus block group(group Q)and thoracic paravertebral nerve block group(group T).Before induction of general anesthesia,patients in the two groups were given 20 ml 0.375%ropivacaine respectively under the guidance of bilateral ultrasound QLB or TPVB.All subjects completed the operation under routine endotracheal intubation general anesthesia,Postoperative patients were treated with sufentanil for patient-controlled intravenous analgesia(PCIA).Changes of mean arterial pressure(MAP)and heart rate(HR)of immediately and 5 min after skin incision were recorded,and the differences of△MBP and△HR were calculated;The range of bilateral abdominal skin sensory block after blocking 15min and 30min was tested and recorded;Record the operation time,the cumulative dosage of sufentanil during operation and the dosage of remifentanil during operation;The resting and motor visual analogue scale(VAS)at 2 h,4 h,6 h,12 h,24 h and 48 h after operation and the number of PCIA compressions at 0～12 h,12～24 h and 24～48 h after surgery were recorded;The time of first pressing analgesic pump,the incidence of remedial analgesia,the score of satisfaction with postoperative analgesia,the time of getting out of bed for the first time,the time of anal exhaust,the occurrence of postoperative adverse reactions(such as nausea and vomiting,dizziness,skin itching,urine retention,etc.)and postoperative hospital stay were recorded.Results:Compared with the ipsilateral side of the Q group,there were more people with abdominal sensory block in the left and right T6,T7,T12,L1 and right T8 segments after 15min block in group T(P<0 05),And the number of patients with abdominal sensory block in T6 and L1 segments of left and right sides after 30min block was more than that of left and right segments(P<0 05);There was no significant difference in the number of abdominal sensory block on both sides of the same segment in the same group at the same time(P>0.05).Compared with Q group,the coughing VAS score of T group at 6 hours after operation was lower(P=0.048<0.05),there was no significant difference in other resting and coughing VAS scores between the two groups.There was no significant difference in the changes of mean arterial pressure and heart rate,the dosage of opioids,the time of the first PCIA compression,the times of PCIA compression in different periods,the incidence of rescue analgesia and the score of postoperative analgesia satisfaction between the two groups(P>0.05).There were no significant differences in the time of getting out of bed for the first time,the time of first anal exhaust,the occurrence of postoperative adverse reactions and postoperative hospital stay between the two groups(P>0.05).Conclusion:Ultrasound-guided lumbar quadratus block and thoracic paraspinal nerve block can provide satisfactory analgesic effect for patients undergoing laparoscopic radical resection of colorectal cancer,and their analgesic effects are similar,and there is no significant difference in accelerating postoperative rehabilitation. |
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