关键词: 肠梗阻, 麻醉方案, 肠道屏障功能, 氧化应激, 炎症反应

Abstract: Objective To investigate the differential effects of the optimization of anesthesia protocols on intestinal barrier function,oxidative stress,and inflammatory response in patients with intestinal obstruction.Methods Ninety-three patients receiving intestinal obstruction surgery in our hospital from January 2019 to January 2022 were enrolled,and classified into two groups according to different anesthesia methods.Control group(n=53) received routine general anesthesia,while experimental group(n=40) received  general anesthesia combined with transverse abdominal plane(TAP) + rectus sheath block block.Then comparison was conducted on intestinal barrier function [diamine oxidase(DAO) activity and endotoxin(ETX)],oxidative stress [catalase(CAT) and epinephrine],inflammatory response [tumor necrosis factor-α(TNF-α) and interleukin6(IL-6)],along with the postoperative time of first anal exhaust,defecation and out-of-bed activity.Results Compared with control group,experimental group had lower intraoperative sufentanil consumption,and shorter postoperative time of first anal exhaust and defecation(all P<0.05).Compared with baseline data,an increase in DAO activity,ETX,TNF-α,IL-6 and epinephrine levels along with a decrease in CAT were observed in both groups at postoperative 1 d and 3 d(all P<0.05).Compared with control group,experimental group had higher DAO activity,ETX,TNF-α,IL-6 and epinephrine levels,and lower CAT levels at postoperative 1 d and 3 d,with statistical difference(all P<0.05).Conclusion Compared with other anesthesia protocol,general anaesthesia combined with TAP + rectus sheath block is more effective for patients receiving intestinal obstruction surgery,which cause less impact on intestinal barrier function and oxidative stress,and can attenuate the inflammatory response.

Key words: intestinal obstruction, anesthesia protocol, intestinal barrier function, oxidative stress, inflammatory response