Effect of quadratus lumborum block on postoperative analgesia and T lymphocyte subsets in the patients receiving transabdominal radical resection of rectal cancer / 中国现代医生

ABSTRACT

Objective To investigate the effect of quadratus lumborum block on postoperative analgesia and T lympho-cyte subsets in patients receiving transabdominal radical resection of rectal cancer, so as to provide clinical references. Methods From May 2016 to November 2017, 30 patients receiving selective radical resection of rectal cancer in our hospital were selected. The random number table was used to divide the patients into quadratus lumborum block group(experimental group) and incision partial infiltration block group (control group), with 15 patients in each group. After induction of general anesthesia, the experimental group underwent ultrasound-guided bilateral anterior lateral quadratus lumborum block. Each side was injected with 0. 375％ ropivacaine of 20 mL. The control group was induced by general anesthesia and 0. 375％ ropivacaine of 40 mL was injected for local infiltration block. The surgery time, volume of blood loss, total infusion volume of propofol, effective analgesia time, the amount of sufentanil infusion every 12 hours after surgery and resting VAS scores at postoperative different time points (2, 6, 12, 24, 36, 48 hours postoperatively) were observed and recorded. Venous blood (1 mL) was drawn 30 minutes before anesthesia(TO), 2 hours after surgery(T1), 1 day after surgery(T2) and 3 days after surgery(T3). T lymphocyte subsets were detected by flow cytometry(CD3+, CD4+, CD8+, CD4+/CD8+). Results Compared with the control group, the dosage of propofol in the experimental group was significantly less than that in the control group (P＜0. 05); the effective analgesia time in the experimental group was significantly longer than that in the control group (P＜0. 0l); the amount of sufentanil in the experimental group was significantly less than that in the control group at 0-12 h and 12-24 h after surgery (P＜0. 05); the resting VAS scores in the experimental group at 6 h and 12 h after the surgery were significantly lower than those in the control group (P＜0. 05); the levels of CD3+, CD4+, CD4+/CD8+ in the experimental group were significantly higher than those in control group at T2 (P＜0. 05). Compared with TO, CD3+, CD4+, CD4+/CD8+ at T1 and T2 in the two groups were significantly lower than those at TO(P＜0. 05); at T2, CD8+ in the control group was significantly lower than that at TO(P＜0. 05). Conclusion Bilateral quadratus lumborum block can significantly improve postoperative analgesia effect in patients receiving radical resection of rectal cancer and reduce the inhibition of T lymphocytes by surgical stress.