Fargaly Omar Sayed, Boules Maged Labib, Hamed Mohamed Ahmed, Aleem Abbas Mohammed Abdel, Shawky Mohammed Ahmed
Department of Anesthesiology, Faculty of Medicine, Fayoum University, Fayoum, Egypt.
Anesthesiol Res Pract. 2022 Mar 28;2022:9201795. doi: 10.1155/2022/9201795. eCollection 2022.
After laparoscopic abdominal surgery, we aim to evaluate the analgesic efficiency of US-directed bilateral transversus abdominis plane block (TAPB) and quadratus lumborum block (QLB).
50 patients aged 18-60 years listed for elective laparoscopic abdomen operation were registered in this study. Cases were randomly allocated into two similar groups: TAPB and QLB groups. The first outcome was the growing morphine consumption on the 1 day postoperatively. The second outcome involved VAS score, first analgesic necessities, and any postoperative complications. Statistical analysis was done with the 2-sample -test, and Mann-Whitney U testing was utilized to compare medians for skewed end points. Qualitative data were introduced as numbers and percentages, and chi-squared testing was utilized to determine the significance.
The median cumulative morphine consumptions on the 1st day were high significantly in the TAPB group than in the QLB group (6 mg [6, 9] vs. 3 mg [3, 6], value ≤0.0001]). The QLB group showed an increase in the median of the time to the first analgesic request in comparison with the TAPB group (17 hours [12, 24] vs. 8 hours [6, 24], ≤ 0.001). In addition, on the 1st day, the mean VAS scoring at rest was lower in the QLB group.
In comparison to the TAPB, the QL block delivers more successful pain relief, has an extended period of analgesic actions, extends interval to the 1 analgesic necessity, is accompanied with lesser morphine consumptions, and may be utilized in multimodal analgesia and opioid-sparing regimens after that laparoscopic operation. This trial is registered with NCT04553991.
在腹腔镜腹部手术后，我们旨在评估超声引导下双侧腹横肌平面阻滞（TAPB）和腰方肌阻滞（QLB）的镇痛效果。
本研究纳入了50例年龄在18至60岁之间、计划进行择期腹腔镜腹部手术的患者。病例被随机分为两个相似的组：TAPB组和QLB组。第一个观察指标是术后第1天吗啡消耗量的增加。第二个观察指标包括视觉模拟评分（VAS）、首次镇痛需求以及任何术后并发症。采用双样本t检验进行统计分析，对于偏态终点，使用曼-惠特尼U检验比较中位数。定性数据以数字和百分比表示，采用卡方检验确定其显著性。
TAPB组术后第1天的吗啡累积消耗量中位数显著高于QLB组（6 mg [6, 9] 对比 3 mg [3, 6]，P值≤0.0001）。与TAPB组相比，QLB组首次镇痛需求时间的中位数增加（17小时 [12, 24] 对比 8小时 [6, 24]，P≤0.001）。此外，在第1天，QLB组静息时的平均VAS评分较低。
与TAPB相比，QL阻滞提供了更成功的疼痛缓解，具有更长的镇痛作用时间，延长了至首次镇痛需求的间隔时间，伴有更少的吗啡消耗量，并且可用于腹腔镜手术后的多模式镇痛和阿片类药物节省方案。本试验已在ClinicalTrials.gov注册，注册号为NCT04553991。
