Liu Qin, Lin Jing-Yan, Zhang Yun-Feng, Zhu Na, Wang Guo-Qiang, Wang Shun, Gao Peng-Fei
Department of Anesthesiology, North Sichuan Medical College, Nanchong 637000,Sichuan,China; Department of Anesthesiology, Suining Central Hospital, Suining 629000, Sichuan, China.
Department of Anesthesiology, North Sichuan Medical College, Nanchong 637000,Sichuan,China; Department of Anesthesiology, Affiliated Hospital of North Sichuan Medical College,Nanchong, 637000,Sichuan,China.
J Clin Anesth. 2020 Jun;62:109742. doi: 10.1016/j.jclinane.2020.109742. Epub 2020 Feb 20.
The aim of the present study was to assess the quality of recovery from anesthesia on patients subjected to laparoscopic radical resection of colorectal cancer under epidural block combined with general anesthesia or general anesthesia by means of Quality of Recovery-15 (QoR-15) questionnaire.
Prospective randomized trial.
The setting is at an operating room, a post-anesthesia care unit, and a hospital ward.
Seventy patients, aging from 65 to 79 years with an American Society of Anesthesiologists physical status II or III, were scheduled to undergo laparoscopic radical resection of colorectal cancer.
Epidural block combined with general anesthesia or general anesthesia.
The QoR-15 was administered by an investigator blind to group allocation before surgery (T), at 24 and 72h after surgery (T and T), and on postoperative day 7 (T). The quality of recovery, as assessed by the score on the QoR-15, was compared between the groups. Besides, the consumption of anesthetics, respiratory recovery time, response time, extubation time, flatus time, the incidence of nausea or vomiting, the consumption of antiemetic and analgesic agents, and the duration of the hospital stay were also recorded.
The QoR-15 scores at T and T were significantly higher in the E + G group compared with the G group (P < 0.05). Among the five dimensions of the QoR-15, physiological comfort, physiological independence, pain, and emotional dimension were significantly better at T in the E + G group, and physiological comfort and pain were significantly better at T in the E + G group.
This study demonstrates that epidural block combined with general anesthesia can improve the early recovery of elderly patients after laparoscopic radical resection of colorectal cancer from the perspective of patients.
本研究旨在通过术后恢复质量-15（QoR-15）问卷评估硬膜外阻滞复合全身麻醉或全身麻醉下接受腹腔镜结直肠癌根治术患者的麻醉恢复质量。
前瞻性随机试验。
手术室、麻醉后护理单元和医院病房。
70例年龄在65至79岁之间、美国麻醉医师协会身体状况为II或III级的患者，计划接受腹腔镜结直肠癌根治术。
硬膜外阻滞复合全身麻醉或全身麻醉。
由对分组情况不知情的研究人员在手术前（T0）、术后24小时和72小时（T₁和T₂）以及术后第7天（T₃）发放QoR-15问卷。比较两组患者通过QoR-15评分评估的恢复质量。此外，还记录麻醉药用量、呼吸恢复时间、反应时间、拔管时间、排气时间、恶心或呕吐发生率、止吐和镇痛药物用量以及住院时间。
与全身麻醉组（G组）相比，硬膜外阻滞复合全身麻醉组（E+G组）在T₁和T₂时的QoR-15评分显著更高（P<0.05）。在QoR-15的五个维度中，E+G组在T₁时的生理舒适度、生理独立性、疼痛和情绪维度显著更好，在T₂时生理舒适度和疼痛显著更好。
本研究表明，从患者角度来看，硬膜外阻滞复合全身麻醉可改善老年患者腹腔镜结直肠癌根治术后的早期恢复情况。
