Department of Anesthesiology and Pain Medicine, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea.
Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Korean J Anesthesiol. 2020 Apr;73(2):158-162. doi: 10.4097/kja.d.19.00016. Epub 2019 May 17.
Commonly used epidural or systemic analgesics for pain control after hip surgery carry risk for potential adverse effects. In contrast, the quadratus lumborum block (QLB) utilizes a simple and easy fascial plane technique and provides a wide area of sensory blockade. Thus, the QLB may be beneficial as analgesia after total hip arthroplasty.
Here, we report the case of an 83-year-old man who received a continuous transmuscular QLB as part of a multimodal analgesia after hardware removal and total hip arthroplasty. The patient received a continuous infusion of 0.2% ropivacaine at 8 ml/h through an indwelling catheter in addition to patient-controlled analgesia with intravenous fentanyl and oral celecoxib. The patient's pain scores did not exceed 4, and no additional analgesics were required until postoperative day 5.
Transmuscular QLB may be a suitable option for multimodal analgesia after total hip arthroplasty.
常用于髋关节手术后疼痛控制的硬膜外或全身镇痛剂存在潜在不良反应的风险。相比之下，竖脊肌平面阻滞（QLB）采用简单易行的筋膜平面技术，提供广泛的感觉阻滞区域。因此，QLB 可能有益于全髋关节置换术后的镇痛。
本文报告了一例 83 岁男性患者，在接受髋关节置换术后的硬件去除和全髋关节置换术后，接受了连续经肌肉 QLB 作为多模式镇痛的一部分。患者通过留置导管以 8ml/h 的速度接受 0.2%罗哌卡因的持续输注，此外还通过静脉注射芬太尼和口服塞来昔布进行患者自控镇痛。患者的疼痛评分未超过 4 分，直到术后第 5 天才需要额外的镇痛药。
经肌肉 QLB 可能是全髋关节置换术后多模式镇痛的合适选择。
