The Clinical Observation Of Ultrasuond-guided Lumbar Quadratus Block On Patients Undergo Radical Gastrectomy For Gastric Cancer

Objective:To observe the effect of ultrasound-guided quadratus lumborum block in the enhanced recovery after surgery of patients undergo radical gastrectomy for gastric cancer.Methods:There were sixty patients?ASA physical?or?,aged 18-65 years?that scheduled to undergo radical gastrectomy for distal gastric cancer included in the study,and separated into two group:group A?combined ultrasound-guided quadratus lumborum block with propofol infused by colsed-loop TCI?,and group B?propofol infused by colsed-loop TCI?.Following data were recorded:the total consumptions of propofol and remifentanil during operation,the extubation time,the time of patients first pressure analgesia pump and first get out of bed and first break wind,number of times of remedial analgesia;the TNF-?and IL-6 concentrations of serum were tested before anesthesia?T1?,an hour after the operation began?T₂?,4h after the operation?T₄?,24h after the operation?T₇?and 48h after the operation?T₈?;the static and dynamic VAS pain scores were recorded at T₄,8h after the operation?T₅?,12h after the operation?T₆?,T₇ and T₈;patients'satisfaction,hospital stays and total hospital-ization expenses.Results:1.The consumption of propofol and remifentanil,the extubation time:The total consumption of propofol in group B was significantly more than group A?P<0.05?;the total consumption of remifentanil in group B was significantly more than group A?P<0.05?;the time of extubation in group B was significantly longer than group A?P<0.05?.2.The time of patients first pressure analgesia pump and first get out of bed and first break wind,the number of times of remedial analgesia:Compared with group A,the time of patients first pressure analgesia pump and first get out of bed and first break wind were significantly increased in group B?P<0.05?;the number of times of remedial analgesia was significantly increased in group B?P<0.05?.3.The TNF-?and IL-6 concentrations of serum:Compared with T1,the TNF-?and IL-6 concentrations of serum in the two groups was significantly higher than T2,T4,T7,T8?P<0.05?;the TNF-?and IL-6 concentrations of serum at T2,T4,T7and T8 in group B were significantly higher than group A?P<0.05?;the serum of TNF-?and IL-6 concentrations at T1 in group B were no significant difference compared with group A?P?29?0.05?.4.The static and dynamic VAS pain scores:the static and dynamic VAS pain scores at T4,T5,T6,T7 and T8 after operation in group B were higher than group A?P<0.05?.5.The patients'satisfaction,hospital stays and total hospital-ization expenses:Compared with group A,the patients'satisfaction was significantly reduced in group B?P<0.05?;the hospital stays and total hospital-ization expenses were significantly increased in group B?P<0.05?.Conclusion:1.Ultrasuond-guided quadratus lumborum block can reduce the dosage of narcotic drugs.2.Ultrasuond-guided quadratus lumborum block can effectively relieve score of pain.3.Ultrasuond-guided quadratus lumborum block can reduce the secretion of proinflammatory factors.4.Ultrasuond-guided quadratus lumborum block can promote enhanced recovery after surgery.