摘要
目的探讨超声引导下星状神经节阻滞对妇科腹腔镜手术患者术后疼痛及睡眠质量的影响。方法选择2022年8月—2023年1月择期全身麻醉下行妇科腹腔镜手术的患者90例,采用随机数字表分为对照组和试验组,每组45例。试验组麻醉诱导前15 min予超声引导下0.25%罗哌卡因5 mL行右侧C6~C7水平星状神经节阻滞(以霍纳综合征为阻滞成功标志),对照组不予阻滞。两组麻醉方案相同,记录术后1 h、3 h、6 h、12 h、18 h、24 h、36 h、48 h静息及运动VAS评分,术前6 h、术后24 h和48 h痛觉阈值(Von Frey纤维丝测定),术前及术后第一天睡眠质量、焦虑、抑郁评分和MMSE评分,以及麻醉相关并发症发生率。结果最终纳入84例患者(对照组43例、试验组41例)。与对照组比较,试验组术后12 h、18 h、24 h静息及运动VAS评分显著降低(P<0.05),术后24 h痛觉阈值显著增高(P<0.05),术后睡眠质量评分显著提高(P<0.05);两组焦虑、抑郁、MMSE评分和并发症发生率比较差异无统计学意义(P>0.05)。结论超声引导下星状神经节阻滞可减轻妇科腹腔镜手术患者术后12~24 h疼痛,提高痛觉阈值及睡眠质量,有助于患者术后早期恢复。
Objective To investigate the effect of ultrasound-guided stellate ganglion block on postoperative pain and sleep quality in patients undergoing gynecologic laparoscopic surgery.Methods 90 patients scheduled for elective gynecologic laparoscopic surgery under general anesthesia from August 2022 to January 2023 were selected and randomly divided into control group and experimental group by random number table,with 45 cases in each group.15 min before anesthesia induction,the experimental group were given ultrasound-guided stellate ganglion block at the C6–C7 level on the right side with 5 mL of 0.25%ropivacaine(with Horner's syndrome as the sign of successful block),while the control group did not receive any block.Both groups followed the same anesthesia protocol.Resting and movement VAS scores were recorded at 1 h,3 h,6 h,12 h,18 h,24 h,36 h,and 48 h after surgery.Pain thresholds(measured by Von Frey filaments)were assessed at 6 h before surgery and 24 h and 48 h after surgery.Sleep quality,anxiety,depression scores,and MMSE scores were evaluated before surgery and on the first day after surgery.In addition,the incidence of anesthesia-related complications was also recorded.Results Ultimately,84 patients were included(43 in the control group and 41 in the experimental group).Compared with the control group,the experimental group showed significantly lower resting and movement VAS scores at 12 h,18 h,and 24 h after surgery(P<0.05),significantly higher pain thresholds at 24 h after surgery(P<0.05),and significantly improved postoperative sleep quality scores(P<0.05).There were no statistically significant differences between the two groups in anxiety,depression,MMSE scores,or complication rates(P>0.05).Conclusion Ultrasound-guided stellate ganglion block can reduce postoperative pain within 12–24 h,increase pain thresholds,and improve sleep quality in patients undergoing gynecologic laparoscopic surgery,facilitating early postoperative recovery.
作者
陆建辉
陈小云
覃梅兰
陈静
LU Jianhui;CHEN Xiaoyun;QIN Meilan;CHEN Jing(Anesthesia and Surgery Center,Wuming Hospital Affiliated to Guangxi Medical University,Nanning 530100,Guangxi,China;Anesthesia Center,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,Guangxi,China)
出处
《右江医学》
2025年第9期791-797,共7页
Chinese Youjiang Medical Journal
基金
广西壮族自治区卫生健康委员会自筹经费科研课题(Z-A20230804)。
关键词
星状神经节阻滞
术后疼痛
睡眠质量
妇科
腹腔镜
stellate ganglion block
postoperative pain
sleep quality
gynecology
laparoscope
