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目的:评价前路腰方肌-阴部神经阻滞联合全麻用于腹腔镜直肠癌手术的改良效果。方法:择期腹腔镜直肠癌根治术(Miles手术)患者64例，ASA分级Ⅰ～Ⅲ级，性别不限，年龄40～78岁，采用随机数字表法分为2组(n n＝32)：前路腰方肌-阴部神经阻滞联合全麻组(QPG组)和前路腰方肌阻滞联合全麻组(QG组)。QPG组术前在超声引导下行双侧前路腰方肌阻滞，每侧注射0.33%罗哌卡因20 ml，然后行神经刺激仪引导下双侧阴部神经阻滞，每侧注射0.33%罗哌卡因10 ml；QG组术前在超声引导下行双侧腰方肌前路阻滞，每侧注射0.33%罗哌卡因20 ml。2组均采用静吸复合麻醉。术毕行舒芬太尼PCIA。术后采用曲马多进行镇痛补救。记录围术期舒芬太尼和瑞芬太尼用量、曲马多使用情况、术后不良反应发生情况以及恢复情况。记录患者术后镇痛满意情况。n 结果:与QG组比较，QPG组围术期舒芬太尼和瑞芬太尼用量降低，曲马多使用率、皮肤瘙痒和恶心呕吐发生率降低，患者术后镇痛满意率升高，苏醒时间、首次下床时间、肛门排气时间和住院时间缩短(n P<0.05)。n 结论:前路腰方肌-阴部神经阻滞联合全麻可更有助于实现低阿片类药物麻醉模式，提高围术期镇痛效果，促进患者预后。“,”Objective:To evaluate the improved efficacy of anterior quadratus lumborum and pudendal nerve block combined with general anesthesia in laparoscopic rectal cancer surgery.Methods:Sixty-four patients of both sexes, of American Society of Anesthesiologists physical status Ⅰ-Ⅲ, aged 40-78 yr, scheduled for elective laparoscopic rectal cancer surgery (Miles), were divided into 2 groups (n n=32 each) by a random number table method: anterior quadratus lumborum and pudendal nerve block combined with general anesthesia group (QPG group) and anterior quadratus lumborum block combined with general anesthesia group (QG group). In QPG group, bilateral anterior quadratus lumborum block was performed under ultrasound guidance before surgery, with 0.33% ropivacaine 20 ml injected on each side, and then bilateral pudendal nerve block was performed under a nerve stimulator guidance, with 0.33% ropivacaine 10 ml injected on each side. In QG group, bilateral anterior quadratus lumborum block was conducted under ultrasound guidance before surgery, and 0.33% ropivacaine 20 ml was injected on each side. Combined intravenous-inhalational anesthesia was used in both groups. Patient-controlled intravenous analgesia was performed with sufentanil. Tramadol was used for analgesic rescue after operation. Perioperative amounts of sufentanil and remifentanil, use of tramadol, postoperative adverse reactions and recovery were recorded. Patient′s satisfaction with postoperative analgesia was recorded.n Results:Compared with QG group, the perioperative consumption of sufentanil and remifentanil was significantly decreased, the requirement for tramadol and incidence of pruritus and nausea and vomiting were decreased, the rate of postoperative satisfactory analgesia was increased, the emergence time, first off-bed time, anal exhaust time, and length of hospital stay were shortened in QPG group (n P<0.05).n Conclusion:Anterior quadratus lumbosum muscle and pudendal nerve block combined with general anesthesia can be more helpful in achieving the anesthesia mode of low-consumption opioids, raising the effect of perioperative analgesia, and promoting prognosis in patients.