| Objective:To explore whether superior laryngeal nerve block combined with abdominal transverse fascia plane block can reduce the intubation response of patients undergoing general anesthesia,reduce the dosage of opioids during anesthesia induction,reduce the pain caused by surgery,and accelerate the perioperative rehabilitation of patients.Methods:In this study,90 patients undergoing gynecological laparoscopic surgery were selected and randomly divided into three groups,A,B,and C,with 30 cases.Group A underwent ultrasound-guided bilateral superior laryngeal nerve block combined with transverse abdominal fascia block,and the dose of sufentanil during anesthesia induction was 0.4μg/kg.Group B underwent ultrasound-guided bilateral superior laryngeal nerve block combined with transverse abdominal fascia block,and the dose of sufentanil during anesthesia induction was 0.2μg/kg.Group C was the control group.Bilateral transverse abdominal fascia block under ultrasound guidance was performed without superior laryngeal nerve block.The dose of sufentanil was 0.4μg/kg.The HR and MAP of the three groups were recorded when they entered the operating room（T1）,1 min before intubation after anesthesia induction（T2）,immediately after intubation（T3）,and 5 min after intubation（T4）.HR and MAP were recorded at the time of 1 min before extubation（T5）,immediately after extubation（T6）,and 5 min after extubation（T7）in the recovery room.The stay time in the recovery room,the number of cases of sore throat,the number of cases of nausea and vomiting within 48 hours after the operation,the first time of intestinal exhaust,the total length of hospital stay,and the time of postoperative discharge were recorded.Results:There was no significant difference in HR at T1among three groups（P>0.05）.Intra group comparison:in group A,HR at T2was significantly higher than that at T2（P<0.05）,and HR at T4was significantly lower than that at T3（P<0.05）;In group B,there was no significant difference in HR at T1,T2,T3and T4（P>0.05）;In group C,the HR at T3was significantly higher than that at T1and T2（P<0.05）.There was no significant difference in MAP at T1among three groups（P>0.05）.Intra group comparison:the map of T4in group A and C was significantly lower than that of T1（P<0.05）,and there was no significant difference between T4and T1in group B（P>0.05）.There was no significant difference in the total infusion volume of propofol,rocuronium and remifentanil among the three groups（P>0.05）;The total infusion dose of sufentanil in group B was significantly lower than that in group A and C（P<0.05）.There was no significant difference among the three groups in sore throat,nausea and vomiting,length of stay,total length of stay,NRS pain score within 48 hours after operation（P>0.05）.The stay time in the recovery room and the the first time of intestinal exhaust in group B were significantly shorter than those in group C（P<0.05）.Conclusions:Ultrasound-guided superior laryngeal nerve block combined with intravenous use of 0.2μg/kg sufentanil has better hemodynamic stability in patients undergoing endotracheal intubation under general anesthesia,reduces the opioids required during intubation,and provides an additional anesthesia induction method for anesthesiologists in clinical work.Ultrasound-guided superior laryngeal nerve combined with transverse abdominal fascia plane block can reduce the use of opioids during perioperative period,shorten the residence time of PACU and the first time of intestinal exhaust. |
