Ann-Chatrin Leonardsen, Østfold Hospital Trust, Postal box code 300, 1714 Grålum, Norway,
Croat Med J. 2021 Apr 30;62(2):137-145. doi: 10.3325/cmj.2021.62.137.
To explore the effects of an anterior quadratus lumborum block (QLB) on opioid consumption, pain, nausea, and vomiting (PONV) after ambulatory laparoscopic cholecystectomy.
This randomized controlled study recruited 70 patients scheduled for ambulatory laparoscopic cholecystectomy from January 2018 to March 2019. The participants were randomly allocated to one of the following groups: 1) anterior QLB (n=25) with preoperative ropivacaine 3.75 mg/mL, 20 mL bilaterally; 2) placebo QLB (n=22) with preoperative isotonic saline, 20 mL bilaterally; and 3) controls (n=23) given only standard intravenous and oral analgesia. The primary endpoint was opioid analgesic consumption. The secondary endpoints were pain (numeric rating scale 0-10) and PONV (scale 0-3, where 0=no PONV and 3=severe PONV). Assessments were made up to 48 hours postoperatively.
The groups did not significantly differ in opioids consumption and reported pain at 1, 2, 24, and 48 hours postoperatively. PONV in the QLB group was lower than in the placebo and control groups.
Preoperative anterior QLB for laparoscopic cholecystectomy did not affect postoperative opioid requirements and pain. However, anterior QLB may decrease PONV.
探讨腹直肌前外侧阻滞（QLB）对腹腔镜胆囊切除术患者术后阿片类药物消耗、疼痛、恶心和呕吐（PONV）的影响。
本随机对照研究纳入了 2018 年 1 月至 2019 年 3 月期间拟行日间腹腔镜胆囊切除术的 70 例患者。将参与者随机分为以下三组：1）QLB 组（n=25），术前双侧给予 3.75mg/mL 罗哌卡因 20mL；2）安慰剂 QLB 组（n=22），术前双侧给予等渗盐水 20mL；3）对照组（n=23），仅给予标准静脉和口服镇痛。主要终点为阿片类镇痛药消耗。次要终点为疼痛（数字评分 0-10）和 PONV（0-3 分，0 无 PONV，3 为严重 PONV）。术后 48 小时内进行评估。
三组患者术后 1、2、24 和 48 小时的阿片类药物消耗和疼痛报告无显著差异。QLB 组的 PONV 低于安慰剂和对照组。
腹腔镜胆囊切除术前行腹直肌前外侧阻滞不会影响术后阿片类药物需求和疼痛。然而，腹直肌前外侧阻滞可能会减少 PONV。
