Kumar G Dilip, Gnanasekar N, Kurhekar Pranjali, Prasad T Krishna
Department of Anaesthesiology and Critical Care, Shri Sathya Sai Medical College and Research Institute, Shri Balaji Vidyapeeth (Deemed to be University), Puducherry, India.
Anesth Essays Res. 2018 Oct-Dec;12(4):919-923. doi: 10.4103/aer.AER_158_18.
Traditional truncal blocks are devoid of visceral analgesia. Quadratus lumborum (QL) block has shown greater efficacy in providing the same.
This study was done to compare the efficacy of transversus abdominal plane (TAP) block versus QL block in providing postoperative analgesia for lower abdominal surgeries.
This was a prospective, randomized, double-blinded study.
Seventy adult patients were randomly allocated into two groups, where Group A received TAP block with 20 ml of 0.25% ropivacaine on each side ( = 35) and Group B received QL block with 20 ml of 0.25% ropivacaine on each side ( = 35). The time of block, duration of surgery, Numerical Pain Intensity Scale (NPIS) score at the 1, 2, 4, 8, 12, 16, and 24 postoperative hours, and the total analgesic drug requirements were noted and compared between the two groups.
Data were analyzed with SPSS version 23 (IBM corporation, Armonk, NY, USA) with independent -test and Chi-square test as appropriate. < 0.05 was considered statistically significant.
The time for first analgesic requirement was 243.00 ± 97.36 min and 447.00 ± 62.52 min and the total analgesic consumption (morphine in mg) was 5.65 ± 1.55 and 3.25 ± 0.78 in Group A and Group B, respectively, both of which were statistically significant ( < 0.01). There was a significant difference in postoperative pain scores (NPIS scale 0-10) at rest, between the two groups, up to 16 h.
Patients who received QL block had a significant improvement in postoperative pain relief with reduced consumption of opioids.
传统的躯干阻滞不具备内脏镇痛效果。腰方肌（QL）阻滞在提供内脏镇痛方面已显示出更高的疗效。
本研究旨在比较腹横肌平面（TAP）阻滞与QL阻滞在下腹部手术术后镇痛中的疗效。
这是一项前瞻性、随机、双盲研究。
70例成年患者被随机分为两组，A组每侧接受20 ml 0.25%罗哌卡因的TAP阻滞（n = 35），B组每侧接受20 ml 0.25%罗哌卡因的QL阻滞（n = 35）。记录两组的阻滞时间、手术时长、术后1、2、4、8、12、16和24小时的数字疼痛强度量表（NPIS）评分以及总镇痛药物需求量，并进行比较。
采用SPSS 23版软件（美国纽约州阿蒙克市IBM公司）进行数据分析，根据情况使用独立样本t检验和卡方检验。P < 0.05被认为具有统计学意义。
A组和B组首次需要镇痛的时间分别为243.00 ± 97.36分钟和447.00 ± 62.52分钟，总镇痛药物消耗量（吗啡毫克数）分别为5.65 ± 1.55和3.25 ± 0.78，两组间均具有统计学意义（P < 0.01）。两组在术后静息时的疼痛评分（NPIS量表0 - 10）在16小时内存在显著差异。
接受QL阻滞的患者术后疼痛缓解明显改善，阿片类药物消耗量减少。
