Department of Anesthesiology, Fujian Provincial Medical College, Fujian Medical University, Fuzhou, China; Division of Anesthesia, Fujian Provincial Hospital, Fuzhou, China.
Department of Anesthesiology, Fujian Provincial Medical College, Fujian Medical University, Fuzhou, China.
Adv Med Sci. 2021 Mar;66(1):41-45. doi: 10.1016/j.advms.2020.12.002. Epub 2020 Dec 22.
This study aimed to evaluate the effects of lateral quadratus lumborum block (QLB) on postoperative pain and recovery in patients undergoing laparoscopic colorectal surgery.
Patients between 18 and 70 years old, diagnosed with colon or rectal cancer, with American Society of Anesthesiologists (ASA) physical status I or II, and scheduled for laparoscopic colorectal surgery were recruited. Patients were excluded if they were allergic to local anesthetics and unable to complete the procedure of puncture or follow-up evaluation. All included patients were randomly allocated to either QLB or Sham group. The primary outcome was perioperative cumulative sufentanil consumption.
There were no significant differences between the groups in anesthetic time, operation time, dosage of propofol, and remifentanil (P > 0.05). Patients in the QLB group had significantly less sufentanil consumption both intraoperatively and postoperatively, compared with the Sham group (P < 0.05). Postoperative VAS pain scores on coughing in the QLB group at 2 h, 6 h, 12 h, 24 h time points and VAS pain score at rest 2 h, 6 h after surgery were significantly lower than in the Sham group (P < 0.05). Compared with the Sham group, time to first ambulation and anal flatus after surgery in the QLB group were significantly shorter (P < 0.05). Significant differences of postoperative rescue analgesic usage and QoR-15 score at 48 h were found between the two groups (P < 0.05).
Ultrasound-guided lateral QLB significantly reduced perioperative opioid consumption, alleviated postoperative pain, shortened the time to first ambulation and anal flatus, and enhanced postoperative recovery of the patients undergoing laparoscopic colorectal surgery.
本研究旨在评估侧方竖脊肌阻滞(QLB)对腹腔镜结直肠手术患者术后疼痛和恢复的影响。
纳入年龄在 18-70 岁之间、诊断为结肠癌或直肠癌、美国麻醉医师协会(ASA)身体状况 I 或 II 级、拟行腹腔镜结直肠手术的患者。对局部麻醉剂过敏且无法完成穿刺或随访评估的患者排除在外。所有纳入的患者均随机分为 QLB 组或 Sham 组。主要结局为围术期累积舒芬太尼消耗量。
两组的麻醉时间、手术时间、丙泊酚用量和瑞芬太尼用量均无显著差异(P > 0.05)。QLB 组患者术中及术后舒芬太尼用量均明显少于 Sham 组(P < 0.05)。QLB 组患者术后咳嗽时的 VAS 疼痛评分在 2 小时、6 小时、12 小时、24 小时时点以及术后 2 小时、6 小时静息时 VAS 疼痛评分均明显低于 Sham 组(P < 0.05)。与 Sham 组相比,QLB 组患者术后首次下床活动时间和术后肛门排气时间明显缩短(P < 0.05)。两组术后 48 小时内的补救性镇痛药物使用率和 QoR-15 评分存在显著差异(P < 0.05)。
超声引导下的侧方 QLB 可显著减少围术期阿片类药物的使用,减轻术后疼痛,缩短首次下床活动和肛门排气时间,促进腹腔镜结直肠手术患者术后恢复。