纳布啡辅助局部浸润麻醉与腰方肌阻滞对结肠癌根治术患者术后镇痛的影响

doi:10.3969/j.issn.1006-6233.2022.02.022

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Abstract Objective: To compare the effect of nalbuphine as an adjuvant to local wound infiltration anesthesia and quadratus lumborum block in patients undergoing laparoscopic radical resection of colon cancer. Methods: A total of 150 patients who planned to undergo laparoscopic radical resection of colon cancer in the Lishui Hospital of Zhongda Hospital affiliated to Southeast University from July 2019 to April 2021 were selected. The patients were randomly assigned to the local wound infiltration anesthesia group (L group), the nalbuphine adjuvant to local wound infiltration anesthesia group (N group) or the quadratus lumbar muscle block group (Q group), 50 patients in each group. Patients in group Q underwent ultrasound-guided bilateral quadratus lumbar muscle block after the operation; group L and group N underwent local infiltration anesthesia of incision, group L had 0.375% ropivacaine, total 40ml; group N had 0.375% ropivacaine + 20mg nalbuphine mixed solution, totally 40ml. NRS was used to evaluate the pain levels of the two groups of patients immediately after returning to the ward in a quiet state and an active state, 2h, 4h, 12h, and 24h after the operation. The number of PCIA compressions within 24 hours after surgery, postoperative nausea and vomiting (PONV), postoperative hypotension, dizziness, skin itching, and lower limb motor function block were recorded. Results: NRS scores in group N and Q at 12h postoperatively quiet state were significantly lower than those in group L, with statistical significance (P<0.05), while there was no statistical significance in NRS scores at 12h postoperatively quiet state between group N and Q (P>0.05). There was no significant difference in NRS scores between the three groups at each time point after operation (P>0.05). The number of PCIA pressing in group L within 24h after surgery was significantly higher than that in group N and Q, with statistical significance (P<0.05). The incidence of lower limb motion block in group Q was significantly higher than that in group L and group N, the difference was statistically significant (P<0.05). The incidence of pruritus in group N was significantly lower than that in group L and Q, with statistical significance (P<0.05). Conclusion: Nalbuphine as an adjuvant to local wound infiltration anesthesia can provide postoperative analgesic effect and duration similar to that of quadratus lumborum block in patients undergoing laparoscopic radical resection of colon cancer, and reduce the incidence of pruritus without affecting the lower limb movement function.

Key words： Quadratus lumborum block Local wound infiltration anesthesia Nalbuphine Laparoscopic radical resection of colon cancer Postoperative analgesia

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	XU Jianfeng
	HONG Min
	HU Jian
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XU Jianfeng,HONG Min,HU Jian, et al. Effect of Nalbuphine as an Adjuvant to Local Wound Infiltration Anesthesia Versus Quadratus Lumborum Block in Patients Undergoing Laparoscopic Radical Resection of Colon Cancer[J]. HeBei Med, 2022, 28(2): 287-291.

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2022.02.022 OR http://www.hbyxzzs.cn/EN/Y2022/V28/I2/287

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