| Objective:In recent years,ultrasound-guided nerve block technique has been gradually used in clinic.It is mostly used in thoracic and abdominal surgery in general anesthesia surgery.This study retrospectively analyzed the influence of ultrasound-guided nerve block on patients’ rapid postoperative recovery and intraoperative hemodynamics in these operations,providing reference for clinical application.Method:According to the inclusion and exclusion criteria,A total of 7747 cases of patients undergoing elective thoracic,orthopaedic and abdominal surgery in our hospital from2016 to 2022 were selected and divided into group N and group A.Group A was general tracheal intubation anesthesia,group N was general tracheal intubation anesthesia combined with regional nerve block,and the postoperative analgesia regimen in both groups was PCIA.The data were collected by referring to the electronic medical record system of hospitalization and anesthesia,the paper records of PACU and telephone return visits.Basic data were sex,age,weight,ASA grading,duration of surgery,surgical method,and surgical type.The main study indicators were intraoperative systolic and diastolic blood pressure fluctuations,intraoperative blood loss,length of stay in the anesthesia recovery room(PACU),NRS score 24 hours after surgery,opioid use rate 24 hours after surgery,length of stay,incidence of postoperative nausea and vomiting,and readhospital admission rate.Application of SPSS 25.0 statistical software,all quantitative data to normality test and f test,normal distribution continuity variables to (?)±s said,non-normal distribution of continuous variables with the median(interquartile range),continuous variables using independent sample t test or the Mann-Whitney U test,Count data were expressed as frequency/percentage,Chi-square test or Fisher exact probability method was used,and P<0.05 was considered statistically significant.Results:In this study,there were no significant differences in patients’ gender,age,body weight,ASA grading,operation duration and other basic data(P > 0.05).Intraoperative blood pressure fluctuation was less in group N than in group A during gastrointestinal surgery(P < 0.05),but no difference was found in other surgeries(P > 0.05).PACU residence time in gastrointestinal surgery was less in group N than in group A(P <0.05),but no difference was found in other surgeries(P > 0.05).Intraoperative blood loss in group N was less than that in group A in thoracic surgery and gastrointestinal surgery(P < 0.05),but no difference was found in other surgeries(P > 0.05).In thoracic surgery,the pain score in group N was lower than that in group A within 12 hours after surgery(P < 0.05).In gastrointestinal surgery,the pain score of group N was lower than that of group A(P < 0.05);In partial hepatectomy,the tracheal intubation extraction time in group N was earlier than that in group A(P < 0.05).In thoracic and abdominal surgery,the additional opioid demand rate in group N was lower than that in group A(P < 0.05),and the incidence of nausea and vomiting in group N was lower than that in group A(P < 0.05).The length of hospital stay between group N and group A was not statistically significant(P > 0.05).There was no significant difference in the readmission rate between group N and group A(P > 0.05).Conclusion:The implementation of ultrasus-guided nerve block stabilized the fluctuation of intraoperative blood pressure during gastrointestinal surgery,reduced the amount of intraoperative blood loss during thoracic surgery and gastrointestinal surgery,reduced the pain score 6 hours after gastrointestinal surgery and 12 hours after thoracic surgery,reduced the rate of additional opioid demand and the occurrence of nausea and vomiting within 24 hours after thoracic and abdominal surgery.It has positive significance for rapid recovery after operation. |
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