竖脊肌平面阻滞联合星状神经节阻滞在老年腹腔镜全子宫切除术中的应用效果

doi:10.3969/j.issn.1003-9198.2025.01.012

Abstract

Abstract: Objective To investigate the effects of erector spinae plane block (ESPB) combined with stellate ganglion block (SGB) in the elderly patients undergoing laparoscopic total hysterectomy (LTH). Methods A total of 116 elderly patients who underwent LTH in Lianyungang Maternal and Child Health Hospital from January 2021 to December 2023 were selected and divided into two groups by random number table method, with 58 cases in each group. The patients in the control group were narcotized by ESPB, and those in the combined group were narcotized by ESPB combined with SGB. The operation indicators, anesthetic drug dosage, VAS score, rescue analgesia, postoperative recovery, stress indicators, adverse reactions, heart rate (HR) and mean arterial pressure (MAP) before anesthesia induction (T0), 5 min after anesthesia (T1) and at the end of operation (T2) were compared between the two groups. Results There were no significant differences in operation time, intraoperative bleeding, time to get out of bed, hospital stay and incidence of adverse reactions between the two groups (P>0.05). The consumption of propofol and sufentanil, pressing times of analgesic pump, rescue analgesia rate and the first postoperative exhaust time in the combined group were lower than those in the control group (P<0.05). At the time of 6, 12 and 24 hours after operation, the VAS score in the two groups gradually decreased, especially in the combined group (P<0.05). The levels of MAP and HR were significantly increased at T1,and then significantly decreased at T2 in the two groups, but the levels of MAP and HR at T1 and T2 in the combined group were lower than those in the control group (P<0.05). After operation, the levels of cortisol (Cor) and substance P (SP) were higher than those before operation in the two groups, especially in the control group (P<0.05). Conclusions ESPB combined with SGB can effectively improve the analgesic effect, reduce the dosage of analgesic drugs, maintain hemodynamic stability, reduce stress response, and is safe and reliable in the elderly patients undergoing LTH.

Key words: erector spinae plane block, stellate ganglion block, laparoscopic total hysterectomy, aged, analgesic effect

CLC Number:

R 614

ZHOU Jing, SUN Luoyang, WANG Ling, MA Jiaxu. Effects of erector spinae plane block combined with stellate ganglion block in elderly patients undergoing total laparoscopic hysterectomy[J]. Practical Geriatrics, 2025, 39(1): 51-55.

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Effects of erector spinae plane block combined with stellate ganglion block in elderly patients undergoing total laparoscopic hysterectomy

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