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超声引导下腰方肌外侧阻滞与腰方肌后侧阻滞用于腹腔镜胆囊切除术后疼痛的随机对照试验

Ultrasound-guided lateral versus posterior Quadratus Lumborum Block for postoperative pain after laparoscopic cholecystectomy: a randomized controlled trial.

作者信息

Ökmen Korgün, Metin Ökmen Burcu, Sayan Erkan

机构信息

Sağlık Bilimleri Üniversitesi, Bursa Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Anestezi ve Reanimasyon Kliniği, Bursa, Türkiye.

Sağlık Bilimleri Üniversitesi, Bursa Yüksek İhtisas Eğitim ve Araştırma Hastanesi, Fizik Tedavi ve Rehabilitasyon Kliniği, Bursa, Türkiye.

出版信息

Turk J Surg. 2019 Mar 1;35(1):23-29. doi: 10.5578/turkjsurg.4161. eCollection 2019 Mar.

Abstract

OBJECTIVES

The aim of the present study was to investigate the effect of ultrasound-guided bilateral posterior quadratus lumborum block (QLB) and lateral QLB on postoperative pain scores after laparoscopic cholecystectomy.

MATERIAL AND METHODS

In this prospective, randomized, single-blind study; 60 patients with elective laparoscopic cholecystectomy operations were randomized into two groups as group P (n= 30): Posterior Quadratus Lumborum Block + IV patient-controlled analgesia (PCA) tramadol and group L (n= 30): Lateral Quadratus Lumborum Block + IV PCA tramadol. Primary outcome measures included the amount of total consumption (24 hours) of tramadol. Secondary outcome measures; Visual Analog Scala (VAS) scores at rest and on movement (postoperative 30th minute, 2nd, 6th, 12th, and 24th hours) were recorded. Adverse effects (nausea and vomiting), additional analgesic requirement, and intraoperative opioid requirement were recorded.

RESULTS

Postoperative total consumption amounts of tramadol and VAS scores (rest and on movement) were compared, and there was no statistically significant difference between the two groups (p> 0.05). There was no statistically significant difference in adverse effects (nausea and vomiting), additional analgesic requirement, and intraoperative opioid requirement between the two groups (p> 0.05).

CONCLUSION

Similar postoperative tramadol consumption values and VAS scores were determined in both lateral QLB and posterior QLB block applications in the results of our study.

摘要

目的

本研究旨在探讨超声引导下双侧腰方肌阻滞(QLB)和外侧腰方肌阻滞对腹腔镜胆囊切除术后疼痛评分的影响。

材料与方法

在这项前瞻性、随机、单盲研究中;60例行择期腹腔镜胆囊切除术的患者被随机分为两组,P组(n = 30):腰方肌后阻滞+静脉自控镇痛(PCA)曲马多,L组(n = 30):腰方肌外侧阻滞+静脉PCA曲马多。主要观察指标包括曲马多的总消耗量(24小时)。次要观察指标;记录静息和活动时的视觉模拟评分(VAS)(术后第30分钟、第2、6、12和24小时)。记录不良反应(恶心和呕吐)、额外镇痛需求和术中阿片类药物需求。

结果

比较两组术后曲马多总消耗量和VAS评分(静息和活动时),两组间无统计学显著差异(p>0.05)。两组间在不良反应(恶心和呕吐)、额外镇痛需求和术中阿片类药物需求方面无统计学显著差异(p>0.05)。

结论

在我们的研究结果中,外侧QLB和腰方肌后阻滞应用中术后曲马多消耗量值和VAS评分相似。

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Quadratus Lumborum Blocks.腰方肌阻滞
Adv Anesth. 2017;35(1):145-157. doi: 10.1016/j.aan.2017.07.007. Epub 2017 Oct 3.
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Abdominal wall blocks in adults.成人腹壁阻滞
Curr Opin Anaesthesiol. 2016 Oct;29(5):638-43. doi: 10.1097/ACO.0000000000000378.

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