竖脊肌平面阻滞与腹横肌平面阻滞在小儿下腹部手术中的应用:一项随机对照试验。

Quadratus Lumborum Block Versus Transversus Abdominis Plane Block in Children Undergoing Low Abdominal Surgery: A Randomized Controlled Trial.

机构信息

From the *Department of Anesthesia, Sütçü İmam University Hospital, Kahramanmaraş; and †Department of Anesthesia, Kocaeli University Hospital, Kocaeli, Turkey.

出版信息

Reg Anesth Pain Med. 2017 Sep/Oct;42(5):674-679. doi: 10.1097/AAP.0000000000000645.

Abstract

BACKGROUND AND OBJECTIVES

Truncal blocks have a place within multimodal analgesia techniques in abdominal surgery. The quadratus lumborum block is a new abdominal truncal block used for somatic analgesia of both the upper and lower abdomen. In this prospective, double-blind, randomized study, we aimed to compare quadratus lumborum block and transversus abdominis plane block in pediatric patients undergoing lower abdominal surgery.

METHODS

Fifty-three children undergoing unilateral inguinal hernia repair or orchiopexy surgery were randomized into 2 groups: transversus abdominis plane block and quadratus lumborum block. All blocks were performed under general anesthesia before surgery. Pain levels were assessed using an FLACC (Face, Legs, Activity, Cry, Consolability) scale.

RESULTS

The study included 50 patients, after excluding 3 patients who were not eligible. The number of patients who required analgesia in the first 24 hours postoperatively was significantly lower in the quadratus lumborum block group (P < 0.05). In the quadratus lumborum block group, the postoperative 30-minute and 1-, 2-, 4-, 6-, 12-, and 24-hour FLACC scores were lower compared with those of the transversus abdominis plane block group (P < 0.05). Parent satisfaction scores were higher in the quadratus lumborum block group (P < 0.05).

CONCLUSIONS

The results of this study showed that in pediatric patients undergoing unilateral inguinal hernia repair or orchiopexy the quadratus lumborum block provided longer and more effective postoperative analgesia compared with the transversus abdominis plane block.

CLINICAL TRIALS REGISTRATION

The trial was registered prospectively at clinicaltrials.gov (NCT02715999).

摘要

背景与目的

躯干阻滞在腹部手术的多模式镇痛技术中有一席之地。腰方肌阻滞是一种新的腹部躯干阻滞技术,用于上腹部和下腹部的躯体镇痛。在这项前瞻性、双盲、随机研究中,我们旨在比较小儿下腹部手术中腰方肌阻滞和腹横肌平面阻滞的效果。

方法

53 名接受单侧腹股沟疝修补术或睾丸固定术的儿童随机分为 2 组:腹横肌平面阻滞组和腰方肌阻滞组。所有阻滞均在全身麻醉下于手术前进行。使用 FLACC(面部、腿部、活动、哭泣、安慰)量表评估疼痛程度。

结果

研究纳入了 50 名患者,排除了 3 名不符合条件的患者。术后 24 小时内需要镇痛的患者数量在腰方肌阻滞组明显较低(P < 0.05)。在腰方肌阻滞组中,术后 30 分钟和 1、2、4、6、12 和 24 小时的 FLACC 评分均低于腹横肌平面阻滞组(P < 0.05)。腰方肌阻滞组的家长满意度评分更高(P < 0.05)。

结论

本研究结果表明,在接受单侧腹股沟疝修补术或睾丸固定术的小儿患者中,与腹横肌平面阻滞相比,腰方肌阻滞可提供更长、更有效的术后镇痛。

临床试验注册

该试验前瞻性地在 clinicaltrials.gov 注册(NCT02715999)。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索