Li Hui-Jie, Ban Xi, Li Jing, Huang Su-Qin
Department of Anesthesiology, Shulan (Quzhou) Hospital, Quzhou 324000, Zhejiang Province, China.
Department of Anesthesiology, Zhejiang Shuren University Shulan International Medical College Affiliated Shulan (Hangzhou) Hospital, Hangzhou 310000, Zhejiang Province, China.
World J Gastrointest Surg. 2025 Aug 27;17(8):105990. doi: 10.4240/wjgs.v17.i8.105990.
The use of an ultrasound-guided quadratus lumborum block (QLB) combined with general anesthesia for patients undergoing colorectal cancer surgery serves as a model for reducing the postoperative stress response, preserving metabolic stability, protecting renal function, and alleviating postoperative pain.
To compare QLB combined with general anesthesia general anesthesia alone in the perioperative stress response, metabolic and renal function, postoperative pain, and recovery outcomes among patients undergoing colorectal cancer surgery.
Clinical data of 116 patients who underwent colorectal cancer surgery at our hospital between July 2023 and August 2024 were collected for retrospective analysis. According to the anesthesia protocol, the patients were divided into the control (general anesthesia, = 58) and experimental groups (QLB combined with general anesthesia, = 58). Physiological indicators such as blood glucose (GLU), lactic acid (LAC), blood urea nitrogen (BUN), and creatinine (CRE) were measured at T0 (pre-surgery), T1 (post-surgery), T2 (6 hours post-surgery), T3 (24 hours post-surgery), and T4 (48 hours post-surgery). The differences between the two groups for each indicator were evaluated using repeated-measures analysis of variance.
The GLU levels from T1 to T4 in the experimental group were significantly lower than those in the control group ( < 0.001), and the LAC levels were also significantly reduced ( < 0.001). The experimental group exhibited superior renal protection based on postoperative BUN and CRE levels ( < 0.05). Furthermore, the postoperative pain score in the experimental group was significantly lower than that in the control group [visual analogue scale (VAS)] scores differed significantly from T2 to T4, < 0.05.
Research has shown that QLB combined with general anesthesia can decrease postoperative GLU and LAC by 8%-15% and 10%-20% ( < 0.001), respectively. It also enhances renal function markers (BUN, CRE, < 0.05) and lowers VAS scores by 15%-30% ( < 0.05). Ultrasound-guided lumbar muscle block with general anesthesia outperforms general anesthesia alone in diminishing stress response, preserving metabolic balance and renal function, and alleviating postoperative pain. This approach offers a more efficient perioperative management strategy for patients undergoing colorectal cancer surgery. It is particularly advantageous for individuals with stress sensitivity, renal impairment, and heightened pain susceptibility.
超声引导下腰方肌阻滞（QLB）联合全身麻醉用于结直肠癌手术患者，可作为减轻术后应激反应、维持代谢稳定、保护肾功能及减轻术后疼痛的范例。
比较QLB联合全身麻醉与单纯全身麻醉在结直肠癌手术患者围手术期应激反应、代谢及肾功能、术后疼痛和恢复结局方面的差异。
收集我院2023年7月至2024年8月期间116例行结直肠癌手术患者的临床资料进行回顾性分析。根据麻醉方案，将患者分为对照组（全身麻醉，n = 58）和实验组（QLB联合全身麻醉，n = 58）。于T0（术前）、T1（术后）、T2（术后6小时）、T3（术后24小时）和T4（术后48小时）测量血糖（GLU）、乳酸（LAC）、血尿素氮（BUN）和肌酐（CRE）等生理指标。采用重复测量方差分析评估两组各指标间的差异。
实验组T1至T4的GLU水平显著低于对照组（P < 0.001），LAC水平也显著降低（P < 0.001）。基于术后BUN和CRE水平，实验组表现出更好的肾脏保护作用（P < 0.05）。此外，实验组的术后疼痛评分显著低于对照组[视觉模拟量表（VAS）]，从T2至T4评分差异显著，P < 0.05。
研究表明，QLB联合全身麻醉可分别使术后GLU和LAC降低8%至15%和10%至20%（P < 0.001）。它还能改善肾功能指标（BUN、CRE，P < 0.05），并使VAS评分降低15%至30%（P < 0.05）。超声引导下腰方肌阻滞联合全身麻醉在减轻应激反应、维持代谢平衡和肾功能以及减轻术后疼痛方面优于单纯全身麻醉。该方法为结直肠癌手术患者提供了更有效的围手术期管理策略。对于应激敏感、肾功能损害和疼痛易感性较高的个体尤其有利。
