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述评:髋关节镜手术中应用竖脊肌平面阻滞的新进展

Editorial Commentary: Quadratus Lumborum Analgesia for Hip Arthroscopy: The New Kid on the (Nerve) Block.

出版信息

Arthroscopy. 2022 Mar;38(3):816-817. doi: 10.1016/j.arthro.2021.08.031.

Abstract

Quadratus lumborum (QL) nerve block is a new technique aimed to improve perioperative analgesia for patients undergoing hip arthroscopy. The QL block targets nerve roots from the lumbar plexus supplying the hip and is an alternative to the fascia iliaca compartment block, which has been shown to have variable effects on pain control while increasing motor weakness and postoperative fall risk. Although a recent Level I study showed decreased opioid consumption without increased motor weakness after QL block compared to sham block, another Level I study reported contrasting results with QL block demonstrating no improvement in pain control or opioid consumption compared to a multimodal pain regime after hip arthroscopy. These differing conclusions from high-level studies indicate further research is needed for QL block and that investigation of other potential nerve block options for hip arthroscopy patients, such as the PENG block, is warranted.

摘要

竖脊肌(QL)神经阻滞是一种新的技术,旨在改善接受髋关节镜检查的患者的围手术期镇痛。QL 阻滞针对供应髋关节的腰丛神经根,是髂筋膜间隙阻滞的替代方法,后者已被证明对疼痛控制的影响不同,同时增加了运动无力和术后跌倒的风险。尽管最近的一项 I 级研究表明,与 sham 阻滞相比,QL 阻滞后阿片类药物的消耗减少,而运动无力没有增加,但另一项 I 级研究报告了相反的结果,与多模式疼痛方案相比,QL 阻滞在髋关节镜检查后并未改善疼痛控制或阿片类药物的消耗。这些来自高级别研究的不同结论表明,需要进一步研究 QL 阻滞,并且有必要研究其他潜在的髋关节镜检查患者的神经阻滞选择,如 PENG 阻滞。

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