关键词: 腹横肌平面阻滞, 根治术, 早期恢复, 超声, 直肠癌, 镇痛效果

Abstract:

Objective To investigate the effect of continuous transverse abdominal plane block on postoperative analgesia and early recovery in patients with radical rectal cancer. Methods 56 patients with rectal cancer treated at the Second Affiliated Hospital of Guangdong Medical University from July 2017 to July 2019 were selected, which were divided into 28 cases, patients with controlled intravenous

analgesia, patients with an ultrasound-guided continuous transverse abdominal plane block. The amount of fluid access and anesthetic use during patient surgery, The numerical rating scale (NRS) of 2h, 6h, 12h, 24h, 48h, 72h cough and resting were recorded; Patient relief, hospitalization time, first exhaust time after surgery, first bed time were recorded; The adverse reactions and complications such as nausea and vomiting after surgery were recorded; Patient recovery was assessed to a postoperative recovery quality scale. Results There was no significant difference between surgical time, anesthesia time, urine volume, propofol dosage, intraoperative bleeding volume, and total fluid volume in the two groups (P>0.05), The usage quantity of Remifentanil in study group less than the control group, The difference is significant (P<0.05); Postoperative 2h, 6h, 12h, 24h, The NRS at cough and resting were lower than the control group, the difference is significant (P<0.05); Postoperative 48h、72h, there was no significant difference

in the NRS at coughing and resting (P>0.05); Preoperative 1d, there was no significant difference in the total score, emotional state, self-care ability, physical comfort, pain, and psychological support scores of the two groups (P>0.05); Postoperative 3d, total score, physical comfort, emotional state, pain, and psychological support scores were higher than in the control group, the difference is significant (P<0.05); There was no significant hospitalization time difference between the two groups (P>0.05); The first hospital discharge time and the first postoperative exhaust time were shorter than the control group, the rates of nausea, vomiting, relief and analgesia were lower than in the control group, the difference was significant (P<0.05). Conclusion Ultrasonic-guided continuous transverse abdominal plane block can significantly improve the postoperative cough and resting analgesia effect in patients with radical rectal cancer, and significantly improve the early recovery condition.

Key words: Transverse abdominal plane block, Radical surgery, Early recovery, Ultrasound, Rectal cancer, Analgesic effect